June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Common antidiabetic drug metformin reduces the development of age-related macular degeneration
Author Affiliations & Notes
  • Gibran S Khurshid
    Ophthalmology, University of Florida, Gainesville, Florida, United States
  • Footnotes
    Commercial Relationships   Gibran Khurshid None
  • Footnotes
    Support  Research to prevent blindness
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 3179 – F0453. doi:
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      Gibran S Khurshid; Common antidiabetic drug metformin reduces the development of age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3179 – F0453.

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Abstract

Purpose : AMD is a debilitating disease affecting the elderly. Currently, there are no definitive treatments that clinicians can offer to prevent AMD onset or progression. Metformin is a relatively well-tolerated and widely used medication, proven successful in diabetes treatment. This study examined whether metformin use is associated with decreased risk of AMD development

Methods : This was a retrospective case-control study that included patients over age 55 who were seen at the University of Florida ophthalmology clinics between June 1, 2011, to June 1, 2017. Cases (n=1947) included patients with ICD-9 diagnostic code for macular degeneration who were followed for at least four visits before their diagnosis. Controls (n=5841) were patients who had at least four visits in that time period without the diagnosis of AMD. Cases and controls were propensity score-matched with a 1:3 ratio for variables such as age, CCI, hypertension, and anemia. Univariate regression analysis was used to determine metformin’s relationship to the development of AMD. Conditional multivariable logistic regression was used to explore this relationship with consideration of the other covariates of the patients.

Results : Patients on metformin had a statistically significant decreased odds ratio of developing AMD when using univariate analysis (OR, 0.39; 95% CI, 0.31-0.49) as well as conditional multivariable logistic regression (OR, 0.58; 95% CI, 0.43-0.79). Because diabetes can act as a prominent confounder, subgroup analysis was performed studying only patients with diabetes. Through conditional multivariable logistic regression, it was illustrated that metformin use was still associated with decreased odds of developing AMD when diabetes was removed as a confounder (OR, 0.70; 95% CI 0.49-0.98). Other medications assessed such as DPP4 inhibitors, SSRIs, tetracyclic antidepressants, and statins were not found to have a statistically significant relationship with AMD incidence.

Conclusions : In this study we found that metformin decreased the likelihood of developing AMD by 42%, suggesting that this ubiquitous antidiabetic drug may contribute to delaying AMD progression or stopping it altogether. We hope that the relationship between metformin and AMD development will be further established with prospective studies in the future.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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