Purpose The aim of this study was to investigate the optical coherence tomography (OCT) parameters that can predict the vision of patients with exudative age-related macular degeneration (AMD) 1 month following intravitreal ranibizumab injection. Patients and methods This is a prospective consecutive case-series study that was conducted on 20 eyes of 18 consecutive patients who received intravitreal ranibizumab injection for exudative AMD. A spectral-domain OCT imaging was done just before and 1 month following the injection. The main outcome measures were the correlations between the postinjection vision and the preinjection OCT parameters. Results A significant reduction was noted in retinal volume at the 3 and 5-mm central circles. The reduction in retinal thickness was statistically significant, while the reduction in other OCT parameters was insignificant. There was a strong correlation between postinjection vision and each of the following: foveal volume at 1 mm, full retinal thickness at the fovea, and retinal pigment epithelium elevation at the fovea (r>0.7, P<0.05). Multivariate analysis showed that the foveal volume (r 2=0.538) was the most important predictor factor for visual acuity, 1 month following ranibizumab injection. Conclusions Foveal volume is the most important factor for vision prediction and can be used as an early visual predictor 1 month following ranibizumab injection in patients with AMD.