AbstractMicro RNAs (miRNAs) regulate gene expression and hundreds of them act in retinal pigment epithelium (RPE), whose degeneration is critical in age‐related macular degeneration (AMD). Repeated injections with anti‐VEGFA (vascular endothelial growth factor A) is the only remedy in wet AMD. We investigated the correlation between the expression of 18 miRNAs involved in the regulation of the VEGFA gene in serum of 76 wet AMD patients and 70 controls. Pharmacogenetic efficacy of anti‐VEGFA treatment was evaluated by the number of injections monitored up to 12 years. In addition, we compared the relative number of deaths in AMD patient and control groups. We observed a decreased expression of miR‐34‐5p, miR‐126‐3p, miR‐145‐5p and miR‐205‐5p in wet AMD patients as compared with controls. These miRNAs are involved in the regulation of angiogenesis, cytoprotection and protein clearance. No miRNA was significantly correlated with the treatment outcome. Wet AMD patients had greater mortality than controls and their survival was inversely associated with the number of anti‐VEGFA injections per year. No association between miRNA expression and mortality was observed. Our study supports the importance of and the need for further research on the role of miRNA regulation in AMD pathogenesis.