Potential Efficacy of Metformin for Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis
Abstract
Topic Metformin, a widely used diabetes medication, has shown potential for treating age-related macular degeneration (AMD) due to its antioxidative, anti-inflammatory, and antiangiogenic properties. This study aims to systematically review and analyze the efficacy of metformin in reducing AMD prevalence. Clinical Relevance Metformin's potential to serve as a treatment for AMD could significantly reduce the burden of vision loss, offering a cost-effective and widely accessible solution. Methods A systematic search was conducted in OVID Embase, OVID MEDLINE, Cochrane Library, and Web of Science databases on May 2, 2024. Both observational and interventional studies were included if they involved oral metformin use before AMD diagnosis. Data were extracted and analyzed using a random-effects model meta-analysis, with subgroup analyses based on study design, AMD subtype, sex, and metformin dosage. Results Eighteen observational studies were identified, which together included a total of 2 683 234 individuals. Nine studies had a case–control design, 7 were retrospective cohort studies, and 2 were cross-sectional studies. The meta-analysis revealed a significant reduction in the odds of AMD among metformin users (pooled odds ratio [OR] = 0.86, 95% confidence interval = 0.79–0.93, P = 0.0002, I2 = 90%). The association was significant in both patients with diabetes (pooled OR = 0.89) and without diabetes (pooled OR = 0.70), although only 2 studies reported nondiabetic ORs.…
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