A new generation of OCT technology was recently introduced and is currently in clinical use. These devices, called Spectral- or Fourier-domain OCT use a spectrometer able to sample more than 20,000 A-scans and, therefore, collect far more data than is possible using the Time-domain system. The Spectral -domain OCT technique offers better axial resolution (5 micron). The aim of this study is to compare the agreement between Spectral-domain OCT and Stratus-domain OCT to evaluate macular morphology in wet age-related macular degeneration in order to decide the treatment timing. We considered seventy-seven randomly chosen consecutive eyes of 77 patients with wet age-related macular degeneration. Inclusion criteria were patients with primary or recurring subfoveal CNV secondary to AMD, including those with predominantly classic, minimally classic or occult lesions with no classic component. All patients underwent OCT examination using Zeiss Stratus OCT 3 and Opko/OTI SLO/OCT Spectral-domain System. During every examination we evaluated the presence of pigment epithelium detachment, sensory retina serous detachment, cystoids macular edema, epiretinal membrane, inner limiting membrane thickening and exudates. Levels of agreement between the two evaluations were quantified by Kappa measures of agreement. Agreement in the evaluation of macular morphology between Spectral-domain OCT and Stratus-domain OCT is strongly dependent on the parameter measured. Substantial agreement was found in the evaluation of sensory retina serous detachment; moderate agreement was found in the evaluation of epiretinal membrane; slight agreement was found in the evaluation of cystoids macular edema, pigment epithelium detachment, inner limiting membrane thickening and exudates. The new Spectral OCTs allow a better evaluation of macular morphologhy of wet age-related macular degeneration.