PURPOSE: To evaluate the natural history of dry age-related macular degeneration (AMD) through advanced retinal pigment epithelium (RPE) analysis and sub-RPE illumination (SRI) data and to elucidate their correlation with disease progression. METHODS: A total of 82 patients with dry AMD were included in this longitudinal study. Spectral-domain optical coherence tomography (SD-OCT) was utilized to evaluate central macular thickness (CMT), central retinal thickness (CRT), foveal outer nuclear layer (ONL) thickness, and ellipsoid zone (EZ) integrity. Advanced retinal pigment epithelium (RPE) analysis software was used to obtain area and volume data at 3mm and 5mm circles, as well as sub-RPE illumination (SRI) assessments within 5mm circles. RESULTS: After exclusions, the final cohort consisted of 54 eyes of 54 patients (29 female), with a mean age of 74.72±8.38years and a mean follow-up period of 13.92±1.7months. Both area (mm CONCLUSION: Initial SRI area may predict the risk of vision loss over a 12-month follow-up period and could serve as a prognostic marker for progression of dry AMD.