Purpose. To evaluate the contribution of the ocular risk factors in the conversion of the fellow eye of patients with unilateral exudative AMD, using a novel semiautomated grading system. Materials and Methods. Single-center, retrospective study including 89 consecutive patients with unilateral exudative AMD and ≥3 years of followup. Baseline color fundus photographs were graded using an innovative grading software, RetmarkerAMD (Critical Health SA). Results. The follow-up period was months. The occurrence of CNV was confirmed in 42 eyes (47.2%). The cumulative incidence of CNV was 23.6% at 2 years, 33.7% at 3 years, 39.3% at 5 years, and 47.2% at 10 years, with a mean annual incidence of 12.0% (95%？ 0.088–0.162). The absolute number of drusen in the central 1000 and 3000？μm ( ) and the absolute number of drusen ≥125 μm in the central 3000 and 6000 μm ( ) proved to be significant risk factors for CNV. Conclusion. The use of quantitative variables in the determination of the OR of developing CNV allowed the establishment of significant risk factors for neovascularization. The long follow-up period and the innovative methodology reinforce the value of our results. This trial is registered with ClinicalTrials.gov NCT00801541. 1. Introduction Age-related macular degeneration (AMD) poses a substantial public health problem worldwide [1–4]. The exudative form is the leading cause of irreversible vision loss in subjects over 65 years of age living in economically developed countries and accounts for >80% of cases of legal blindness associated with the disease [5–7]. Risk estimation is crucial in order to provide adequate patient monitoring. Fellow eyes of individuals with unilateral exudative AMD should receive the utmost attention since they are known to have an increased risk of developing choroidal neovascularization (CNV) [4, 5, 8, 9]. The role of retinal imaging in AMD has long been recognized. Several studies have concluded that digital imaging is reliable for the purpose of grading AMD, both in clinical practice and in clinical trials [10, 11]. The International Classification and Grading System [12] was created to provide a uniform and internationally accepted nomenclature and grading system for the disease, based on color fundus photography’s morphological findings. Implementation of this system in large cohort epidemiological studies helped establishing significant determinants for the development of wet AMD [4, 13–15] and led to the creation of a fundus photography-based severity scale by the AREDS group [16]. This simplified scale uses a point
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