PURPOSE: To evaluate the effects of immunosuppressive therapy on the development and progression of age-related macular degeneration (AMD) in patients with an immune-mediated inflammatory disease (IMID). METHODS: This is a retrospective cohort study. Data were obtained from TriNetX, a global database of electronic medical records. The analysis utilized the largest network in TriNetX, comprised of 171,583,261 patients from 18 countries. Kaplan-Meier analysis was used to estimate the probability of predefined AMD subcategories between patients with IMID who were prescribed an immunosuppressants and patients who were not. RESULTS: After 1:1 propensity score matching, equal-sized cohorts of patients in each group were generated for predefined IMIDs. We found that AMD was more prevalent in patients who received an immunosuppressant for systemic lupus erythematosus (SLE), Crohn's disease, rheumatoid arthritis, sarcoidosis, Sjogren's syndrome, giant cell arteritis and all IMIDs combined. CONCLUSIONS: The use of immunosuppressants in patients with some IMIDs appears to be associated with an increased risk of AMD. Further research is warranted in order to fully understand the complex relationship between immunosuppressive therapy and AMD.