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Diabetic retinopathy, one of the microvascular complications of diabetes, has become a leading cause of blindness in developed countries.The disease’s pathogenesis is complex and involves inflammation and oxidative stress, which eventually lead to retinal microvascular disease and neurodegenerative changes.A large body of clinical and basic research evidence shows that metformin can improve diabetic retinopathy and delay its onset and progression.Metformin exerts protective effects on retinal microangiopathy and retinal cells via AMP-activated protein kinase-dependent and -independent pathways.Metformin can improve retinal cell autophagy, apoptosis and senescence by reducing the oxidative stress response and regulating mitochondrial energy metabolism.Metformin clinical and basic research provides a new approach to treating diabetic retinopathy and a potential direction for developing drugs.This article reviews the progress of clinical and basic research on metformin’s protective effects against diabetic retinopathy.