In this issue of JAMA Ophthalmology, Blitzer and coauthors1 present findings from a large national database of health insurance claims that are suggestive of an association of metformin with protection against age-related macular degeneration (AMD). Given the burden of vision impairment secondary to advanced AMD, the lack of proven therapies for atrophic AMD, and the burden of treatment associated with neovascular AMD, interventions aimed at preventing AMD are urgently needed. As such, the findings reported1 are of great interest. While the authors hypothesize about the role of metformin as a potential intervention for AMD, the results need to be cautiously interpreted in line with the limitations that are at play when conducting case-control studies with administrative data, as acknowledged by the authors.1
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McGuinness MB, Kasza J, Guymer RH. Is There a Case for Case-Control Studies in the Exploration of Retrospective Data Sets? JAMA Ophthalmol. 2021;139(3):309–310. doi:10.1001/jamaophthalmol.2020.6328
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