Age-related macular degeneration (AMD) is one of the leading causes of irreversible central vision loss among older adults in developed countries. Identifying individuals at risk of developing AMD or experiencing rapid disease progression remains a major clinical challenge, as conventional imaging techniques do not always detect subtle changes at the preclinical stage. This review aims to summarize current evidence on molecular biomarkers supporting the diagnosis, prognosis, and monitoring of AMD. A total of 31 studies, identified through searches of the PubMed, Scopus, and Web of Science databases (2007–2025), were included. Studies were selected according to predefined inclusion and exclusion criteria and assessed for methodological quality. As this was a narrative review, the protocol was not registered. The review discusses genetic, protein, microRNA (miRNA), and metabolic biomarkers reflecting inflammatory processes, oxidative stress, and angiogenesis. Most biomarkers remain at the experimental stage due to a lack of standardization and limited validation. Integration of molecular data with optical coherence tomography (OCT) and OCT angiography offers promising opportunities for personalized diagnosis and disease monitoring. Key limitations of the available evidence include small study populations and the lack of standardized biomarker assessment methods. Overall, the findings of this review highlight the potential of multiparametric diagnostic models to improve early detection of AMD and optimize patient management.