Higher PED volumes (Q3, Q4) were linked to VA decline at all locations (<i>P</i> < 0.001).<h4>Conclusions</h4>Assessment of the cumulative effects of retinal fluid volumes during anti-VEGF therapy using time-dependent biomarker modeling revealed notable associations with risk of atrophy, fibrosis, and VA decline.<h4>Financial disclosures</h4>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article. This evidence concerns the gene VEGFA and Atrophy.