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The purpose of this study is to compare the use of metformin in patients with both exudative and non-exudative age-related macular degeneration (AMD) versus control populations.

Retrospective review of three age- and sex-matched cohorts from 1/1/2004 to 12/31/2013: patients with exudative AMD, a cohort of dry AMD patients, and a cohort of patients without AMD. The primary endpoint was the incidence of metformin use in all of the cohorts.

There were 1512 patients, with 504 in each of the three cohorts. There was no difference in the prevalence of diabetes between cohorts. Compared to patients with dry AMD, patients with no AMD had increased likelihood of metformin use (p = 0.0168, OR 1.66 (1.09–2.51). There was no difference in the likelihood of metformin use between exudative AMD patients and non-AMD controls.

There appears to be an increased incidence of metformin use in patients without AMD compared to patients with dry AMD. Metformin’s current role in the treatment of anti-aging diseases makes it a plausible target for use in the treatment of AMD, particularly dry AMD.

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The datasets generated during and/or analysed during the current study are not publicly available due to the sensitive protected health information of the involved subjects per Mayo Clinic policy.

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This study was made possible using the resources of the Rochester Epidemiology Project, which is supported by the National Institute on Aging of the National Institutes of Health under Award Number R01AG034676. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This work was also supported by Research to Prevent Blindness, New York, NY and the VitreoRetinal Surgery Foundation, Minneapolis, MN. None of the funding sources had any involvement in study design; collection, analysis, or interpretation of the data; writing the report; or the decision to submit for publication.

Department of Ophthalmology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

Matthew R. Starr, Lauren A. Dalvin, Jackson E. AbouChehade, Maria Garcia, Saumya M. Shah, Raymond Iezzi & Sophie J. Bakri

Mayo Clinic School of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

Department of Health Sciences Research/Biomedical Statistics and Informatics, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL, 32224, USA

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Data collection and analysis: MRS, LAD, JEA, GMD, MG, SMS. Statistical analysis: DO. Data interpretation: MRS, LAD, RI, SJB. Manuscript preparation: MRS, LAD, JEA, GMD, MG, SMS, DO, RI, SJB.

Correspondence to Raymond Iezzi or Sophie J. Bakri.

The authors declare no competing interests.

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Starr, M.R., Dalvin, L.A., AbouChehade, J.E. et al. Incidence of metformin use in patients with age-related macular degeneration versus normal controls: A population-based study in Olmsted County, Minnesota. Eye (2022). https://doi.org/10.1038/s41433-022-02245-6

DOI: https://doi.org/10.1038/s41433-022-02245-6

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