Effects of Metformin on Mitochondrial Health and Oxidative Stress in Age-Related Macular Degeneration: A Systematic Review
Abstract
Age-related macular degeneration (AMD) is a chronic, progressive condition and a leading cause of irreversible central vision loss in older patients. It is driven by oxidative stress, mitochondrial dysfunction, chronic inflammation, and degeneration of retinal pigment epithelium (RPE) cells. Current AMD treatments include lifestyle modifications, nutritional supplements, and/or anti-vascular endothelial growth factor therapies and primarily aim to slow disease progression. As a result, interest has grown in repurposing established medications with potential cytoprotective properties. Metformin, a widely-used anti-diabetic agent, has been proposed as a candidate due to its anti-inflammatory and mitochondrial-modulating effects. We conducted a systematic review to identify studies published between January 2015 and November 2025 that evaluate metformin therapy in (1) adults with AMD and (2) experimental retinal models designed to replicate AMD-related degeneration or pathogenesis. Comparators included individuals with AMD who were not taking metformin therapy, were untreated, and/or were given standard treatment therapy. Outcomes of interest included in the review focused on clinical endpoints of AMD incidence and severity and mechanistic endpoints of mitochondrial function, oxidative stress markers, and cellular senescence. This systematic review includes evidence from epidemiologic, clinical, and experimental studies to link molecular mechanisms with observed disease…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Metformin as an adjuvant in breast cancer treatment
- Metformin Lysosomal Targeting: A Novel Aspect to Be Investigated for Metformin Repurposing in Neurodegenerative Diseases?
- Aberrant HSF1 signaling activation underlies metformin amelioration of myocardial infarction in mice
- Metformin induces ZFP36 by mTORC1 inhibition in cervical cancer-derived cell lines
- Protein Interaction Network for Identifying Vascular Response of Metformin (Oral Antidiabetic)
- Preventing Long COVID With Metformin
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.