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BACKGROUND: The determination of pulsatile ocular blood flow (POBF) by measuring intraocular pressure pulse is a reliable way of evaluating choroidal blood flow. METHODS: We studied ocular haemodynamic abnormalities by examining the choroidal blood flow using POBF in patients with age-related macular degeneration (AMD). RESULTS: POBF was lower in patients with exudative AMD than in patients with non-exudative AMD and normal subjects. CONCLUSION: The decreased choroidal blood flow may induce choroidal neovascularization via angiogenic factor induced by hypoxia in patients with exudative AMD. Further studies of choroidal circulation, which may be important for the understanding the mechanism of AMD, are needed.