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Objective <p>The primary objective of this systematic review and meta-analysis was to evaluate the association between diabetic retinopathy (DR) and age-related macular degeneration (AMD).</p> Methods <p>We searched databases including PubMed/Medline, Scopus, EMBASE, Web of Science (WOS) from their inception to 10th of May 2025 using comprehensive search terms. We included observational studies that reported an association between diabetic retinopathy and age-related macular degeneration. Two reviewers independently conducted study selection, data extraction and assessed study quality. The Newcastle Ottawa scale (NOS) was utilized for risk of bias (ROB) assessment. We used random-effects models for meta-analysis, and heterogeneity was evaluated using the I2 statistic and Q Cochrane test. Meta-regression and subgroup analyses were performed to explore sources of heterogeneity. Publication bias was assessed using Doi plot, LFK index, Egger’s test and the trim-and-fill method. Sensitivity analyses were also conducted using leave-one-out approach.</p> Results <p>The literature search retrieved 6,440 records, and after full-text screening of 220 articles, 12 studies were included<b>.</b> The meta-analysis of all studies demonstrated a non-significant negative association between DR and AMD (OR = 0.94; 95% CI: 0.56–1.58; <i>p</i>-value = 0.82), with substantial heterogeneity across studies (I<sup>2</sup> = 98.15%, <i>p</i>-value &lt; 0.001). Meta-regression analysis did not identify any variables that significantly influenced the pooled effect size. Similarly, sub-group analyses based on study design, geographical region, and study quality revealed no significant differences between categories. The majority of included studies (8 out of 12) had low a low risk of bias (High quality), and tests for publication bias detected no considerable publication bias. Sensitivity analyses confirmed the robustness of our results.</p> Conclusions <p>Our findings suggest that there is no association between diabetic retinopathy and age-related macular degeneration. However, due to the unadjusted effect size and high statistical heterogeneity, further prospective cohort studies with robust methodology are needed to confirm our findings.</p>

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Association between diabetic retinopathy and age-related macular degeneration: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2026年2月24日

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  • Mohammadreza Ghasemi,
  • Alireza Ghasemi,
  • Jina Behjati,
  • Homayoun Nikkhah

摘要

Objective

The primary objective of this systematic review and meta-analysis was to evaluate the association between diabetic retinopathy (DR) and age-related macular degeneration (AMD).

Methods

We searched databases including PubMed/Medline, Scopus, EMBASE, Web of Science (WOS) from their inception to 10th of May 2025 using comprehensive search terms. We included observational studies that reported an association between diabetic retinopathy and age-related macular degeneration. Two reviewers independently conducted study selection, data extraction and assessed study quality. The Newcastle Ottawa scale (NOS) was utilized for risk of bias (ROB) assessment. We used random-effects models for meta-analysis, and heterogeneity was evaluated using the I2 statistic and Q Cochrane test. Meta-regression and subgroup analyses were performed to explore sources of heterogeneity. Publication bias was assessed using Doi plot, LFK index, Egger’s test and the trim-and-fill method. Sensitivity analyses were also conducted using leave-one-out approach.

Results

The literature search retrieved 6,440 records, and after full-text screening of 220 articles, 12 studies were included. The meta-analysis of all studies demonstrated a non-significant negative association between DR and AMD (OR = 0.94; 95% CI: 0.56–1.58; p-value = 0.82), with substantial heterogeneity across studies (I2 = 98.15%, p-value < 0.001). Meta-regression analysis did not identify any variables that significantly influenced the pooled effect size. Similarly, sub-group analyses based on study design, geographical region, and study quality revealed no significant differences between categories. The majority of included studies (8 out of 12) had low a low risk of bias (High quality), and tests for publication bias detected no considerable publication bias. Sensitivity analyses confirmed the robustness of our results.

Conclusions

Our findings suggest that there is no association between diabetic retinopathy and age-related macular degeneration. However, due to the unadjusted effect size and high statistical heterogeneity, further prospective cohort studies with robust methodology are needed to confirm our findings.