Emerging strategies in drug repurposing for decreasing the risk of age-related macular degeneration

Mar 10, 2026Expert opinion on drug discovery

New drug reuse approaches to lower the risk of age-related vision loss

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Abstract

Metformin use may be associated with a modest reduction in age-related macular degeneration (AMD) risk.

Age-related macular degeneration (AMD) is primarily driven by oxidative stress, inflammation, and immune dysregulation.
Preclinical studies indicate that metformin can protect retinal cells by activating AMP-activated protein kinase (AMPK).
Population-based studies suggest that metformin may reduce AMD risk in both diabetic and non-diabetic individuals.
Other potential pharmacological agents for AMD include statins, glyburide, L-DOPA, fluoxetine, and nutraceuticals like curcumin and melatonin.
Personalized prevention strategies for AMD could utilize AI and systems biology to incorporate genetic and metabolic data.

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INTRODUCTION: Vision loss in older adults is largely driven by age-related macular degeneration (AMD), characterized by progressive central visual field damage and functional decline. While current options for wet and dry AMD are limited and expensive, drug repurposing represents a promising strategy to accelerate the discovery of effective, accessible treatment by leveraging medications with established safety profiles. Notably, anti-diabetic agents including metformin, sulfonylureas, glucagon-like peptide-1 receptor agonists (GLP-1RAs), and insulin have emerged as modulators of the retinal pigment epithelium (RPE) function, photoreceptors, and retinal vascular integrity.

AREAS COVERED: This review highlights the roles of oxidative stress, inflammation, and complement-mediated immune dysregulation in AMD pathogenesis, alongside preclinical data demonstrating metformin's protective effects via AMP-activated protein kinase (AMPK) activation. Population-based studies and meta-analyses further suggest a modest reduction in AMD risk associated with metformin use in both diabetic and non-diabetic cohorts. Additional pharmacological agents include statins, glyburide, L-DOPA, fluoxetine, dimethyl fumarate, and nutraceuticals such as curcumin, melatonin, and N-acetylcysteine.

EXPERT OPINION: Early AMD prevention through repurposed therapeutics, guided by AI-driven design and systems biology, may enable personalized care via multimodal risk stratification incorporating genetic, metabolomic, and microbiome data. Rigorous, stratified clinical trials integrating bioinformatics and precision medicine are essential to validate the most effective candidates.

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Emerging strategies in drug repurposing for decreasing the risk of age-related macular degeneration

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