September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
The effect of oral metformin on vitreous advanced glycation end-product content in patients with proliferative diabetic retinopathy
Author Affiliations & Notes
  • Ricardo Lamy
    Ophthalmology, University of California, San Francisco, San Francisco, California, United States
  • Max Kudisch
    Ophthalmology, University of California, San Francisco, San Francisco, California, United States
  • Kornwipa Hemarat
    Ophthalmology, University of California, San Francisco, San Francisco, California, United States
  • Qingyun Liu
    Ophthalmology, University of California, San Francisco, San Francisco, California, United States
  • Jacquelyn D. Kemmer
    Ophthalmology, University of California, San Francisco, San Francisco, California, United States
  • Napang Kedkovid
    Ophthalmology, University of California, San Francisco, San Francisco, California, United States
  • Samuel D Good
    Ophthalmology, University of California, San Francisco, San Francisco, California, United States
  • Alvina Han
    Ophthalmology, University of California, San Francisco, San Francisco, California, United States
  • Jay M Stewart
    Ophthalmology, University of California, San Francisco, San Francisco, California, United States
  • Footnotes
    Commercial Relationships   Ricardo Lamy, None; Max Kudisch, None; Kornwipa Hemarat, None; Qingyun Liu, None; Jacquelyn Kemmer, None; Napang Kedkovid, None; Samuel Good, None; Alvina Han, None; Jay Stewart, None
  • Footnotes
    Support  Research to Prevent Blindness; That Man May See, Inc; Juvenile Diabetes Research Foundation; NIH P30 DK063720.
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 6313. doi:
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      Ricardo Lamy, Max Kudisch, Kornwipa Hemarat, Qingyun Liu, Jacquelyn D. Kemmer, Napang Kedkovid, Samuel D Good, Alvina Han, Jay M Stewart; The effect of oral metformin on vitreous advanced glycation end-product content in patients with proliferative diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6313.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Advanced glycation end-products (AGEs) are markers for damage that occurs throughout the body due to chronic exposure to elevated glucose levels. Metformin is commonly prescribed to diabetic patients for glucose control and has various other effects at the cellular level including a reduction in oxidative stress and inflammation and stabilization of mitochondrial function. The purpose of this study is to determine whether oral metformin reduces AGE accumulation in the vitreous of patients with diabetic retinopathy.

Methods : Patients undergoing vitrectomy at UCSF Medical Center and San Francisco General Hospital were enrolled prospectively and provided consent to donate vitreous specimens for analysis. Undiluted vitreous samples were frozen at -80C immediately upon collection. Vitreous aliquots (150 μL) from patients with proliferative diabetic retinopathy taking oral metformin (n=6), patients with proliferative diabetic retinopathy not taking oral metformin (n=7), and non-diabetic patients (n=8) were thawed and analyzed on a black ELISA plate in a fluorescence spectrophotometer at excitation and emission wavelengths of 370 nm and 440 nm, respectively. Autofluorescence intensity (in arbitrary units), an indicator of AGE content, was compared among groups using one-way ANOVA followed by Tukey post-hoc test.

Results : The mean fluorescence (± standard deviation) was 185.0 (± 48.6) in diabetic patients taking metformin, 281.1 (± 138.4) in diabetic patients not taking metformin, and 159.7 (± 46.7) in non-diabetic patients. The difference between diabetic patients not taking metformin and non-diabetic patients was statistically significant (P<0.05). The level in diabetic patients taking metformin demonstrated a trend toward reduction compared to diabetic patients not taking metformin, but this difference did not reach statistical significance in this exploratory study.

Conclusions : Vitreous autofluorescence, corresponding to AGE content, is increased in diabetic patients compared to non-diabetic controls. Further studies with a larger sample size are necessary to determine whether oral metformin use is associated with reduced AGE accumulation in the vitreous in diabetic retinopathy.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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