ABSTRACT
An 84-year-old man presents with a past medical history of abdominal aortic aneurysm, diabetes type II, hypertension, and hypercholesterolemia. He underwent a coronary artery bypass 5 months ago, and during the immediate postoperative period, he experienced atrial fibrillation for which he was started on amiodarone. His other medications are aspirin, atorvastatin, fosinopril, glipizide, and carvedilol twice daily, including one dose at bedtime. He described a progressive decrease in his vision OU over 3 months and additional worsening 3 weeks ago in his left eye. He denies any symptom suggestive of temporal arteritis and his erythrocyte sedimentation rate is normal. On examination, his visual acuity is 20/20 OD and 20/30 OS. There is a 0.9 log unit RAPD OS. Dilated fundus exam revealed marked asteroid hyalosis OD and optic disc edema OU, shown in Figures 14.1 and 14.2, Goldman perimetry shows visual field loss OU, and illustrated in Figures 14.3 and 14.4.
