Detection of Geographic Atrophy Guided by Optical Coherence Tomography Sub-RPE Illumination Analysis in Patients With Intermediate Age-Related Macular Degeneration

<b>Purpose:</b> To evaluate the prevalence of geographic atrophy (GA) lesions in patients with a diagnosis of intermediate age-related macular degeneration (iAMD). <b>Methods:</b> A retrospective cross-sectional study was performed of patients with an International Classification of Diseases, 10th Revision, diagnosis of iAMD. The primary outcome was the percentage of eyes diagnosed with iAMD with an undocumented GA lesion identified on imaging. Multiple logistic regression was used to assess risk factors for atrophic lesions in patients with iAMD. <b>Results:</b> The study included 690 eyes of 428 patients with a diagnosis of iAMD. The mean age was 79.4 ± 8.4 years, and 66.3% of patients were women. Forty-nine eyes (7.1%) were graded as having GA lesions, and 34% of these eyes had foveal involvement. The mean visual acuity (VA) was better in patients without GA lesions than in patients with GA lesions (72.9 ± 12.9 letters vs 66.4 ± 13.8 letters; <i>P =</i> .001). No systemic comorbidity was associated with an increased risk for GA lesions in this cohort. <b>Conclusions:</b> A notable proportion of eyes diagnosed with iAMD by eye care providers had underlying GA lesions in this real-world cohort. The use of optical coherence tomography as an adjunctive tool helped increase the detection of early GA in these patients.