PURPOSE: To describe the visual outcomes 2 years after photodynamic therapy in Japanese patients with age-related macular degeneration (AMD) with or without polypoidal choroidal vasculopathy (PCV) lesions. METHODS: Sixty-three eyes of 63 consecutive patients with AMD or AMD + PCV who underwent photodynamic therapy were included in this study. Fluorescein and indocyanine green angiography were performed to diagnose AMD and AMD + PCV. Change in mean visual acuity and recurrence of active lesion during the follow-up period up to 2 years were assessed. RESULTS: Patients with typical AMD maintained visual acuity for 2 years after photodynamic therapy. For patients with AMD + PCV, the visual acuity was maintained during the first year but started decreasing by 0.09 logarithm of the minimum angle of resolution units per 3 months (95% confidence intervals [CI], 0.06-0.14) after 1 year. Moreover, patients with AMD + PCV had 82% higher risk of a recurrence of active lesions for each increase in 3 months of follow-up time after 1 year; this suggested that the risk of recurrence had increased later in follow-up after 1 year. Recurrence of active PCV lesions and massive subretinal hemorrhages were the main reasons for the late worsening of visual acuity. CONCLUSION: The visual acuity after photodynamic therapy in AMD patients was maintained for 2 years after the initial treatment. Patients with AMD + PCV had stable visual outcome within 1 year but not after 1 year; there are risks of late recurrences and massive hemorrhages after 1 year in patients with AMD + PCV.