To determine the relationship between delayed patchy choroidal filling and morphologic and functional outcomes among eyes treated with ranibizumab or bevacizumab. Cohort study. Comparison of Age-related Macular Degeneration Treatment Trials participants were assigned randomly to ranibizumab or bevacizumab on a monthly or as-needed schedule. Presence of delayed patchy choroidal filling and morphologic and functional outcomes were evaluated among eyes with gradable fluorescein angiography at baseline (n= 973) and at 1 year (n= 860) eyes. Delayed filling was present in 75 (7.7%) of 973 eyes at baseline. Eyes with incident delayed filling at 1 year (23 [2.9%] of 798) showed a mean decrease of 1.7 letters in visual acuity, whereas eyes without incident delayed filling had a mean improvement of 8.1 letters (difference [Δ],-9.8; 95% confidence interval[CI] , -15.8 to -3.9; P < .01). Eyes with incident delayed filling had a larger increase in mean total lesion area of choroidal neovascularization (3.00mm(2)) than eyes without incident delayed filling (0.56mm(2); Δ, 2.4; 95% CI, 0.4 to 4.4; P= .02). The proportion with incident delayed filling at 1 year was similar among eyes treated with ranibizumab (10 [2.4%] of 413) or bevacizumab (13 [3.3%] of 385; P= .53) and among eyes treated monthly (12 [3.1%] of 388) or as needed (11 [2.7%] of 410; P= .83). Delayed patchy choroidal filling was uncommon at baseline. Although only a small percentage of eyes demonstrated delayed filling during the first year of anti-vascular endothelial growth factor treatment, these eyes had worse visual acuity and a larger increase in total lesion area of choroidal neovascularization.