Age-related macular degeneration (AMD) is one of the leading causes of vision loss among older adults.
It affects millions of people around the world and is especially common after the age of 55. As people live longer, the number of people with AMD is expected to keep increasing, making it an important public health problem.
AMD damages a small but very important part of the retina called the macula. The retina is the light-sensitive layer at the back of the eye, while the macula is responsible for sharp central vision. This part of the eye allows people to read, recognize faces, drive, and see fine details. When the macula becomes damaged, everyday tasks become much more difficult.
In the early stages, AMD may not cause obvious symptoms. As the disease gets worse, people may notice blurred vision, dark or empty spots in the center of their vision, or straight lines appearing wavy.
There are two advanced forms of AMD. Geographic atrophy, also known as dry AMD, develops when cells in the macula slowly die. Wet AMD happens when abnormal blood vessels grow underneath the retina and leak blood or fluid, causing rapid damage.
Although medicines can help treat wet AMD, they usually require repeated injections into the eye. These treatments can slow vision loss but are expensive and inconvenient.
There is currently very limited treatment for geographic atrophy in many parts of the world, including the UK and Europe. Because of this, researchers have been searching for safe and affordable ways to prevent AMD from becoming worse.
A new study from the University of Liverpool suggests that metformin, a medicine that has been used safely for decades to treat type 2 diabetes, could become one of those options.
Metformin lowers blood sugar by helping the body respond better to insulin. It is one of the most commonly prescribed diabetes medicines because it is effective, inexpensive, and generally well tolerated.
The researchers followed about 2,000 adults who took part in Liverpool’s diabetic eye screening program over five years. Instead of relying only on medical records, the scientists carefully examined detailed photographs of each participant’s retina to identify changes caused by AMD. This approach allowed them to measure disease progression much more accurately.
The research team compared people who were taking metformin with those who were not. They also considered other important factors that could influence the results, including age, sex, and how long participants had lived with diabetes.
After taking these differences into account, the researchers found that people taking metformin were 37% less likely to develop more serious forms of AMD during the five-year study period. The odds of disease progression were significantly lower among metformin users, suggesting that the medicine may help slow the development of the condition.
Scientists have suspected for several years that metformin might offer protection against AMD, but previous studies mainly relied on insurance claims or health records. This new research is considered stronger because it directly examined eye photographs to determine the severity of the disease.
Lead researcher Dr. Nick Beare said the findings are encouraging because most people with AMD still have very limited treatment options. He believes the next important step is to test metformin in carefully designed clinical trials to find out whether it can safely prevent or slow AMD in larger groups of patients.
Although these results are promising, the study does not prove that metformin prevents AMD. It shows a strong association, but only randomized clinical trials can confirm whether the medicine directly protects eyesight. People should not start taking metformin unless it has been prescribed by their doctor, as every medicine has possible side effects and may not be suitable for everyone.
If future clinical trials confirm these findings, metformin could become an affordable new way to help protect vision in older adults who are at risk of AMD. Since the medicine is already widely used around the world, it could potentially reach patients much more quickly than a completely new drug.
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The study was published in BMJ Open Ophthalmology.
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