14th August 2020

A 72-year old man attends a GP appointment, complaining of loss of vision

A 72-year old man attends a GP appointment, complaining of loss of vision. He describes a two year history of progressive visual loss. This has now reached the point where he can no longer see people’s faces – there appears to be a ‘black spot’ where their faces should be. He has no past medical history documented in the GP records and ruefully admits that he has not seen a doctor for many years. Fundoscopy is performed which shows significant macular oedema bilaterally. On general examination the patient is hypertensive. As part of your assessment you request some routine bloods, which are significant for a raised cholesterol of 7.8mmol/L (normal <5.2mmol/L) and a random blood glucose of 14.2mmol/L (normal 4-8mmol/L).

Which of the following is the most likely cause of this patient’s loss of vision? 

Select the SINGLE most appropriate option from the list below. Select ONE option only.