Thiele S, Nadal J, Pfau M, et al. - In this investigation involving 34 patients (39 eyes), mean age was 74.4 ± 6.7 (± SD) years, researchers described early stages of geographic atrophy (GA) development in age-related macular degeneration (AMD) and determined the prognostic value of structural precursor lesions in eyes with intermediate (i) AMD on the subsequent GA progression. Five precursor lesions (phenotypes 1–5) prior to GA development have been identified: large, sub-retinal pigment epithelial drusen (n = 19), reticular pseudodrusen (RPD, n = 10), refractile deposits (n = 4), pigment epithelial detachment (n = 4) and vitelliform lesions (n = 2). Precursor lesions showed a significant correlation with the subsequent (sqrt) GA progression rates with RPD (phenotype 2) being associated with the fastest GA enlargement. The findings show the prognostic relevance of iAMD phenotyping for subsequent GA progression, emphasising the role of structural AMD features across various AMD stages.