Metformin use associated with reduced incidence of intermediate AMD

A press release issued by the University of Liverpool, UK, announced that treatment with a common diabetes medication may be associated with less development of intermediate age-related macular degeneration (AMD), according to the senior author Nicholas AV Beare, MD. He is a reader in the Department of Eye and Vision Science, University of Liverpool, and St. Paul’s Eye Unit, Liverpool Ophthalmic Reading Centre, Liverpool University Hospital NHS Foundation Trust, both in Liverpool, UK.

This finding was based on the results of a study published in BMJ Open Ophthalmology¹ that patients with diabetes who were over 55 years of age and being treated with metformin were “37% less likely to develop the intermediate stage of AMD over a 5-year period compared to those not taking metformin,” according to the press release.

Metformin is described as “the first-line treatment for type 2 or adult-onset diabetes. It reduces the production of sugar (glucose) in the liver along with other effects that benefit diabetes. Metformin also has anti-aging effects, including being antioxidant, anti-inflammatory, and stimulating house-keeping functions and energy production in cells (pro-mitochondria).”

If the anti-AMD effects are true, the benefits of the drug are that it is inexpensive and may ease the treatment burden of AMD.

Imaging study

In their study, the investigators evaluated ocular images from 2,000 patients who attended the routine diabetic eye disease screening program in Liverpool over 5 years. The researchers recounted that they assessed the images for the presence and severity of AMD. They then compared the patients treated with metformin to those who were not. After adjustment for age, sex, and duration of diabetes, they reported that “the odds of developing intermediate AMD over 5 years in the metformin group was 0.63 compared to the no metformin group (95% confidence range, 0.43 to 0.92).”

The basis for the study, they explained, was that “a potential benefit from metformin in AMD has been suspected before, but this is the first study to grade AMD from eye photographs. Previous studies on metformin have used secondary information on AMD such as GP diagnostic codes [International Classification of Diseases, Tenth Revision, Clinical Modification] or insurance claims in the US.”

Beare is quoted in the press release as saying, “…this is a great breakthrough in our search for new treatments. What we need to do now is test metformin as a treatment for AMD in a clinical trial. Metformin has the potential to save many people’s sight.”

Reference

1. Romdhoniyyah DF, Alshukri A, Parry DG, Harding S, Beare NAV. Metformin and incidence of age-related macular degeneration in people with diabetes: a population-based 5-year case-control study. BMJ Open Ophthalmol. 2026;11: published online February 3. https://bmjophth.bmj.com/content/11/1/e002339