Evidence map›Paper›PMID 40803555›Full record

ArticleOphthalmology. Retina2026

Long-Term Metformin Use and Reduced Risk of Age-Related Macular Degeneration: A Large Database Study.

Alexander T Hong, Ivan Y Luu, Jeremy D Keenan, Jay M Stewart

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Ophthalmology. Retina, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Alexander T HongKeck School of Medicine of University of Southern California, Los Angeles, California.
Ivan Y LuuKeck School of Medicine of University of Southern California, Los Angeles, California.
Jeremy D KeenanFrancis I. Proctor Foundation, University of California, San Francisco, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, San Francisco, California.
Jay M StewartFrancis I. Proctor Foundation, University of California, San Francisco, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, San Francisco, California; Department of Ophthalmology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California. Electronic address: jay.stewart@ucsf.edu.

Funding

Rapid-Prototyping and Design CoreP30EY002162 · NEI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI ULLIAN, ERIK M · 1985 to 2024
$16.8M
NEI NIH HHS P30 EY002162
6 · The paper itself

Abstract

objectiveTo evaluate the association between metformin use and the risk of developing age-related macular degeneration (AMD) among patients with diabetes, with a focus on exposure duration and AMD subtypes.

designRetrospective cohort study.

participantsPatients were identified from the TriNetX network using International Classification of Diseases, 10th Revision, and Current Procedural Terminology codes for diabetes and ophthalmic care. Patients aged ≥60 years with diabetes and no documentation of AMD were included in the cohort.

methodsPatients were required to have no AMD diagnoses at 2 eye care visits ≥1 year apart, with the second visit serving as the index event for analysis. The main exposure was yearly metformin use for ≥5 years, with subanalysis up to 10 years. The outcome was incident AMD. Propensity score matching controlled for potential confounders, including demographics, comorbidities, medications, laboratory values, and health care utilization. The association between metformin and AMD was assessed using survival analysis. Results were reported as hazard ratios (HRs) with 95% confidence intervals (CIs).

main outcome measuresThe primary outcome was a new diagnosis of AMD. Secondary outcomes included a new diagnosis of dry AMD and wet AMD.

resultsAfter propensity score matching, the main cohort analysis included 7496 patients, of whom 3748 had ≥5 consecutive years of metformin use. Incident AMD was documented in 122 (3.3%) patients who had been exposed to metformin and 184 (4.9%) who had not (HR, 0.68; 95% CI, 0.54-0.85). The metformin group had lower rates of both dry AMD (HR, 0.69; 95% CI, 0.53-0.90) and wet AMD (HR, 0.84; 95% CI, 0.50-1.39), although the association with wet AMD was not statistically significant. The metformin use for ≥6 consecutive years showed consistent protective effects; 1 to 4 years showed weaker associations.

conclusionsProlonged metformin use in patients with diabetes was associated with a reduction in AMD risk in this claims database. These findings suggest a potential protective role for metformin, warranting further exploration of its long-term effects on AMD prevention. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Indexed as

Diabetes Mellitus, Type 2Macular DegenerationMetforminAgedAged, 80 and overDatabases, FactualFemaleFollow-Up StudiesHumansHypoglycemic AgentsIncidenceMaleMiddle AgedPropensity ScoreRetrospective StudiesRisk AssessmentHypoglycemic AgentsMetforminAge-related macular degenerationDiabetes mellitusMetforminPropensity score

Identifiers

PMID40803555
PMCPMC13619462

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.