Imaging of the retina, originally by stereoscopic fundus photography and later by optical coherence tomography (OCT), has been essential to the diagnosis and monitoring of progression of age-related macular degeneration. Manual grading of color photographs acquired during the Age-Related Eye Disease Study to detect and quantify drusen and pigmentary changes led to a detailed severity scale that stratified 5-year risk of late AMD into 9 categories, with risk estimates ranging from 1% to 50%.1 The high resolution of spectral-domain OCT now allows visualization of the retinal microanatomy. Drusen and focal areas of hyperpigmentation are associated with specific findings on OCT images, and great progress has been made in using artificial intelligence (AI) techniques to identify and quantify these features.2,3 The combination of advanced OCT imaging and segmentation of retinal features using AI allows accurate and reproducible assessments to be made on a large-scale basis.