Abstract
Background: Age-related macular degeneration (AMD) in its late stages is a leading cause of sight loss in developed countries. Some previous studies have suggested that metformin may be associated with a reduced risk of developing AMD, but the evidence is inconclusive.
Aims: To explore the relationship between metformin use and development of AMD among patients with type 2 diabetes in the UK.
Methods: A large, population-based retrospective open cohort study with a time-dependent exposure design was carried out using IQVIA Medical Research Data, 1995-2019. Patients aged ≥40 with diagnosed type 2 diabetes were included.
The exposed group were those prescribed metformin (with or without any other antidiabetic medications); the comparator (unexposed) group were those prescribed other antidiabetic medications only. The exposure status was treated as time-varying, collected at 3-monthly time intervals.
Extended Cox proportional hazards regression was used to calculate the adjusted hazard ratios for development of the outcome, newly diagnosed AMD.
Results: A total of 173,689 patients, 57% male, mean (SD) age 62.8 (11.6) years, with incident type 2 diabetes and a record of one or more antidiabetic medications were included in the study. Median follow-up was 4.8 (IQR 2.3-8.3, range 0.5-23.8) years. 3,111 (1.8%) patients developed AMD. The adjusted hazard ratio for diagnosis of AMD was 1.02 (95% CI 0.92 - 1.12) in patients prescribed metformin (with or without other antidiabetic medications) compared to those prescribed any other antidiabetic medication only.
Conclusion: We found no evidence that metformin was associated with risk of age-related macular degeneration in primary care patients requiring treatment for type 2 diabetes.
Aims: To explore the relationship between metformin use and development of AMD among patients with type 2 diabetes in the UK.
Methods: A large, population-based retrospective open cohort study with a time-dependent exposure design was carried out using IQVIA Medical Research Data, 1995-2019. Patients aged ≥40 with diagnosed type 2 diabetes were included.
The exposed group were those prescribed metformin (with or without any other antidiabetic medications); the comparator (unexposed) group were those prescribed other antidiabetic medications only. The exposure status was treated as time-varying, collected at 3-monthly time intervals.
Extended Cox proportional hazards regression was used to calculate the adjusted hazard ratios for development of the outcome, newly diagnosed AMD.
Results: A total of 173,689 patients, 57% male, mean (SD) age 62.8 (11.6) years, with incident type 2 diabetes and a record of one or more antidiabetic medications were included in the study. Median follow-up was 4.8 (IQR 2.3-8.3, range 0.5-23.8) years. 3,111 (1.8%) patients developed AMD. The adjusted hazard ratio for diagnosis of AMD was 1.02 (95% CI 0.92 - 1.12) in patients prescribed metformin (with or without other antidiabetic medications) compared to those prescribed any other antidiabetic medication only.
Conclusion: We found no evidence that metformin was associated with risk of age-related macular degeneration in primary care patients requiring treatment for type 2 diabetes.
| Original language | English |
|---|---|
| Journal | British Journal of Ophthalmology |
| Early online date | 3 Feb 2022 |
| DOIs | |
| Publication status | E-pub ahead of print - 3 Feb 2022 |
Keywords
- Age-related macular degeneration
- type 2 diabetes
- metformin
- primary care
- electronic health records
Access to Document
- GokhaleK2022Metfor
This article has been accepted for publication in British Journal of Ophthalmology, 2022 following peer review, and the Version of Record can be accessed online at http://dx.doi. org/10.1136/bjophthalmol2021-319641 © Authors (or their employer(s)) 2022. Reuse of this manuscript version (excluding any databases, tables, diagrams, photographs and other images or illustrative material included where a another copyright owner is identified) is permitted strictly pursuant to the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC-BY-NC 4.0) http://creativecommons.org BMJ Authors Self-Archiving Policy, September 2018 https://creativecommons.org/licenses/by-nc/4.0/