A prospective fluorescein angiographic study of 45 patients with unilateral age-related exudative maculopathy revealed at the 4-year follow-up that 14 (31%) had developed neovascular membranes in the fellow eyes. Age, drusen size and confluence, as well as pigmentary changes of these 14 were compared with the corresponding characteristics of the 31 eyes that remained non-exudative (atrophic). No significant differences were found. Among the 14 eyes that developed exudative maculopathy, visual acuity (Snellen) deteriorated 3-4 steps in 6 eyes (43%), 5-6 steps in 4 eyes (28.5%), and 7-8 steps or more in 4 eyes (28.5%). Among the 31 eyes that remained non-exudative, visual acuity was unchanged in 20 eyes (64%), deteriorated 1-2 steps in 7 eyes (23%), 3-4 steps in 3 eyes (10%), and 5-6 steps in 1 eye (3%). Social blindness (6/60 or less in the better eye) was found among 79% of the patients who had developed exudative maculopathy, whereas the figure was 19% among patients who still had atrophic macular degeneration.