This study investigates the relationship between ellipsoid zone (EZ) integrity on spectral domain optical coherence tomography (SD-OCT) and visual acuity (VA) in patients with dry age-related macular degeneration (AMD). Using a machine learning-enabled feature extraction tool, quantitative EZ parameters were derived from SD-OCT images. The analysis revealed significant correlations between EZ integrity metrics and VA. Eyes with excellent VA (≥20/25 Snellen) exhibited higher EZ integrity, including less EZ attenuation, thicker EZ-RPE thickness, and higher EZ intensity, compared to eyes with worse VA (≤20/40 Snellen). Eyes with geographic atrophy (GA) in the foveal region showed compromised EZ integrity compared to those without GA. Baseline EZ integrity metrics were predictive of future VA loss. These findings suggest that quantitative SD-OCT measurements of EZ integrity could detect early changes in dry AMD and serve as valuable indicators for predicting future functional outcomes. The study also highlights the importance of EZ integrity assessment in understanding and managing dry AMD. The results indicate that EZ integrity is closely linked to visual function and can be used as a biomarker for disease progression and treatment response. The study underscores the potential of EZ integrity as a key parameter in the evaluation and management of dry AMD.This study investigates the relationship between ellipsoid zone (EZ) integrity on spectral domain optical coherence tomography (SD-OCT) and visual acuity (VA) in patients with dry age-related macular degeneration (AMD). Using a machine learning-enabled feature extraction tool, quantitative EZ parameters were derived from SD-OCT images. The analysis revealed significant correlations between EZ integrity metrics and VA. Eyes with excellent VA (≥20/25 Snellen) exhibited higher EZ integrity, including less EZ attenuation, thicker EZ-RPE thickness, and higher EZ intensity, compared to eyes with worse VA (≤20/40 Snellen). Eyes with geographic atrophy (GA) in the foveal region showed compromised EZ integrity compared to those without GA. Baseline EZ integrity metrics were predictive of future VA loss. These findings suggest that quantitative SD-OCT measurements of EZ integrity could detect early changes in dry AMD and serve as valuable indicators for predicting future functional outcomes. The study also highlights the importance of EZ integrity assessment in understanding and managing dry AMD. The results indicate that EZ integrity is closely linked to visual function and can be used as a biomarker for disease progression and treatment response. The study underscores the potential of EZ integrity as a key parameter in the evaluation and management of dry AMD.