The authors describe a condition called retinal pigment epithelial (RPE) ooze in patients with age-related macular degeneration. Patients with ooze have a neurosensory retinal detachment, a slowly progressive indiscrete leakage of fluorescein dye from the level of the retinal pigment epithelium, and no other signs of choroidal neovascularization. Sixteen patients with RPE ooze were followed for a mean of 4.5 years without treatment. Nine patients had a single round or oval area of leakage. In seven of these patients, choroidal neovascular membranes developed, with moderate to poor visual outcomes. The other seven patients had multiple smaller areas of leakage from the level of the RPE. None of these patients had a choroidal neovascular membrane, and all had resolution of the subretinal fluid with good final visual acuities. Patients with discrete round or oval RPE oozes appear to be at a high risk for the development of more definite choroidal neovascular membranes and vision loss.