OBJECTIVE: To study the relationship of ARMD severity to anxiety and depression in three European countries: France, Germany and Italy. METHODS: Patients with wet ARMD were included in a retrospective cross-sectional survey. Socio-demographic and medical data were collected during a visit by a retina specialist. Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale (HADS). Two thresholds were used to dichotomize visual acuity (VA): 20/40 for the best eye (BE) and 20/200 for the worst eye (WE). Comparisons with general population matched on age and gender were possible for the German patients (Hinz, 2004). Analysis of variance was performed to estimate the effect of each eye adjusted on age, gender and country. RESULTS: A total of 360 patients were included. The patients (40% male) averaged 77 years of age and 2.3 years of disease duration. VA was 0.49 LogMAR on the BE the day of the visit. In the German population, ARMD patient anxiety score was higher than the general population both in male (5.4 vs. 4.7) and female (7.7 vs. 5.7). Some associations were found between the severity of the disease and the depression score (BE P <0.004) and (WE P <0.12) while no association was found on the anxiety score. The prevalence of severe depression according to HADS was 0% in the less severe (BE > = 20/40; WE > = 20/200) but 7.6% in the most severe group (BE < 20/40; WE < 20/200). CONCLUSION: Associations were found between ARMD and depression and anxiety as measured by the HADS. The severe depression prevalence rate increases when both eyes are affected by the disease.