Purpose : Changes in lipid metabolism, chronic inflammation and increased oxidative stress have been discussed as patho-etiogenetic drivers in age-related macular degeneration (AMD). Systemic medication, such as lipid-lowering drugs (LLD) and anti-diabetic drugs, affect these pathways and may therefore also play a role in AMD pathogenesis. We aimed to investigate associations of commonly used systemic drugs with AMD prevalence in the European population. Methods : We included 38,694 adults from 14 population-based studies from the European Eye Epidemiology (E3) consortium. We performed multivariable logistic regression modelling to examine medication use association with prevalence of AMD as well as late AMD. Analyses were carried out separately by study and results pooled using random effects meta-analysis. We conducted these analyses separately for LLD, anti-diabetic drugs, non-steroidal anti-inflammatory drugs (NSAID), and L-Dopa. Results : Between studies, mean age ranged from 61.5 ± 7.1 to 82.6 ± 3.8 years and prevalence ranged from 12.1% to 64.5% and from 0.5% to 35.5% for any and any late AMD, respectively. In the meta-analysis of our multivariable models, LLD and anti-diabetic drugs were associated with lower AMD prevalence (OR 0.85, 95% confidence interval (CI)=0.79 - 0.91 and OR 0.78, 95% CI=0.66 - 0.91). We found no association with late AMD or with any other medication. Conclusions : Our study shows an association of LLD and anti-diabetic drug use with lower AMD prevalence across multiple European cohorts. Our findings support the importance of metabolic processes in the complex etiology of AMD.< Réduire