PURPOSE: Basic research has shown that early processes in the development of age-related macular degeneration (ARMD) are related to inflammation. The purpose of this manuscript is to evaluate the association of ARMD and the use of anti-inflammatory medications. METHODS: A nested case control study was carried out among male patients at the Veteran's Medical Center in Birmingham, Alabama (BVAMC). Cases were 614 patients with incident ARMD diagnosed between 1997 and 2001 by International Classification of Disease, Ninth Revision code. Controls (4526) were individuals with no diagnosis of ARMD by International Classification of Disease, Ninth Revision coding and matched on age. Formulary records of all medications dispensed through the Veteran's Administration Medical Center were accessed. All oral or injectable drugs with anti-inflammatory properties were considered anti-inflammatory medications for study purposes. Topical ophthalmic and dermatologic preparations were not considered anti-inflammatory. RESULTS: Among veterans with a diagnosis of ARMD 24% (150/614) patients had filled a prescription for any of the anti-inflammatory medications compared with 60% (3051/4526) individuals in the control population. Individuals who had filled a prescription for anti-inflammatory drugs had an 85% reduced odds of having a diagnosis of ARMD (odds ratio 0.15, 95% confidence interval 0.12-0.18). CONCLUSIONS: The results of this study suggest that veterans who had filled a prescription for anti-inflammatory medications had a reduced risk of ARMD. Further studies are needed to confirm this result.