OBJECTIVES: This cross-sectional, observational, case-control study was undertaken in 4 EU countries and Canada to characterize and quantify the humanistic and economic burden of illness in AMD patients compared to elderly controls. Data for Germany are reported herein. METHODS: Of 401 bilateral neovascular AMD patients and 471 elderly non-AMD (control) subjects, 83 AMD patients and 93 controls were recruited in Germany. Physicians recorded demographic and treatment information. Patients completed a telephone survey of the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), the EuroQol (EQ-5D), the Hospital Anxiety and Depression Scale (HADS), and history of falls, fractures and health resource utilization. The impact of AMD on functioning and health resource utilization was compared between AMD patients and controls using chi-square tests, analysis of variance, and multivariate regression models. RESULTS: The adjusted mean (95% CI) NEI-VFQ overall scale score was 51.31 (37.72, 64.90) in AMD patients, which was substantially worse than in controls (96.31 [82.75, 109.87]) after adjusting for better-seeing eye visual acuity, age, gender, and co-morbid diseases (p <0.0001). AMD patients reported significantly more depression symptoms than controls on the HADS scales (adjusted mean depression scores: 6.17 vs. 2.69, p<0.0001) after adjusting for covariates. AMD affected patients' perceptions of their general health significantly more than control subjects measured by the EQ-5D (0.69 vs. 0.79, p = 0.0360). Average annual per patient costs were 12,156 Euro in AMD patients versus 1,287 Euro in controls. Of the 12,156 Euro per AMD patient, 9% were AMD drug costs, 14% were direct vision-related medical costs, 9 % were direct other medical costs, and 68% were non-medical costs. CONCLUSION: In Germany, bilateral AMD patients reported substantially worse quality of life, poorer vision-related functioning, and higher economic burden compared to controls without AMD. AMD poses significant emotional and financial burdens to the society.