Evidence mapPaperPMID 41816092Full record

ArticleOphthalmology science2026

Protective Role of Metformin in Glaucoma: Prospective Cohort Study, Meta-Analysis, and Drug-Target Mendelian Randomization.

Can Can Xue, Hengtong Li, Miao Li Chee, Zhi Da Soh, Marco Yu, Raghavan Lavanya, Yih-Chung Tham, Nicholas Y Q Tan, Rachel Chong, Ching-Yu Cheng

Abstract read
In one paragraph

Article in Ophthalmology science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Can Can XueSingapore Eye Research Institute, Singapore National Eye Centre, Singapore.
Hengtong LiCentre for Innovation and Precision Eye Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Miao Li CheeSingapore Eye Research Institute, Singapore National Eye Centre, Singapore.
Zhi Da SohSingapore Eye Research Institute, Singapore National Eye Centre, Singapore.
Marco YuSingapore Eye Research Institute, Singapore National Eye Centre, Singapore.
Raghavan LavanyaSingapore Eye Research Institute, Singapore National Eye Centre, Singapore.
Yih-Chung ThamSingapore Eye Research Institute, Singapore National Eye Centre, Singapore.
Nicholas Y Q TanSingapore Eye Research Institute, Singapore National Eye Centre, Singapore.
Rachel ChongSingapore Eye Research Institute, Singapore National Eye Centre, Singapore.
Ching-Yu ChengSingapore Eye Research Institute, Singapore National Eye Centre, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Preclinical studies suggested that metformin use may protect against glaucoma through multiple mechanisms, while observational studies reported mixed results. To clarify this association, we conducted a prospective cohort study, a meta-analysis, and a drug-target Mendelian randomization (MR) analysis. Design: A prospective cohort study, meta-analysis, and drug-target MR analysis. Participants: The cohort analysis included 24 206 UK Biobank participants with diabetes who were free of glaucoma at baseline. Methods: In the UK Biobank, we examined the association between metformin use and incident glaucoma using multivariable Cox regression. A random-effect meta-analysis was performed to synthesize existing evidence on the association between metformin and glaucoma from human studies. For drug-target MR, genetic variants close to 5 metformin targets genes were weighted by their genetic association with glycated hemoglobin A1c (HbA1c) to proxy their therapeutic effects. The genome-wide association study summary data for primary open-angle glaucoma (POAG) was sourced from the International Glaucoma Genetics Consortium, including only individuals of European ancestry. The drug-target MR analysis was performed using the generalized least squares-inverse variance weighted model. Main Outcome Measures: Incident glaucoma in UK Biobank, pooled effect estimates from meta-analysis, and MR-derived causal estimates for metformin's effect on POAG. Results: During a mean follow-up of 12.1 ± 2.8 years, 841 glaucoma cases occurred, with an incident rate of 2.87 per 1000 person-years. Metformin use was associated with a 19% lower glaucoma risk (hazard ratio, 0.81; 95% confidence interval [CI], 0.67-0.97; Conclusions: Convergent evidence from cohort, meta-analytic, and genetic analyses supports a possible protective association between metformin use and glaucoma among patients with diabetes. These findings support the need for randomized clinical trials to evaluate metformin's potential as a preventive glaucoma therapy in individuals with diabetes. Financial Disclosures: The authors have no proprietary or commercial interest in any materials discussed in this article.

Indexed as

Drug-targetGlaucomaMendelian randomizationMetforminUK Biobank

Identifiers

PMID41816092
PMCPMC12973693

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.