Age-related macular degeneration (AMD) is a prevalent ophthalmologic condition hypothesised to involve inflammation in the macula. The use of acetylcholinesterase inhibitors (AChEIs) for Alzheimer's disease treatment may have anti-inflammatory effects, but it is unclear if they modify AMD risk.
An original investigation published in JAMA Ophthalmology concluded that AChEIs could help lower the risk of AMD. They found that AD patients on AChEIs had a slightly lower hazard of AMD development compared to untreated patients. AChEIs reduced AMD risk, while memantine showed no association with AMD incidence.

Does using acetylcholinesterase inhibitors (AChEIs), commonly prescribed for Alzheimer's disease, influence the incidence of age-related macular degeneration? This study investigated the association between AChEI medications and the incidence of AMD.
This retrospective cohort study was conducted at healthcare facilities within the US Department of Veterans Affairs (VA) healthcare system (from January 2000 to September 2023). Patients aged 55-80 with AD and no prior AMD diagnosis in the VA database were included in this investigation. Exposure was AChEIs prescribed for AD treatment, and the outcome was the first diagnosis of AMD.
The results of this investigation are:
A total 21 823 veterans with AD, with a mean age of 72.3 years, were included.
A total of 21 313 male and 510 female participants were included.
As the Propensity score–matched the Cox model revealed, each additional year of AChEI treatment was tied to a 6% lower hazard of AMD (hazard ratio, 0.94).
This study found a slight decrease in AMD risk for veterans with AD taking AChEIs. More research is needed to confirm cause and effect and validate these results across diverse populations.
Reference:
Sutton SS et al. Alzheimer Disease Treatment With Acetylcholinesterase Inhibitors and Incident Age-Related Macular Degeneration. JAMA Ophthalmol. Published online January 04, 2024. doi:10.1001/jamaophthalmol.2023.6014