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62-year-old white female presents for an initial visit with complaints only related to refractive issues.

  • BCVA 20/20 OD, OS, OU.
  • Significant medical history includes hypercholesterolemia, for which she is medicated and reports ‘good’ total cholesterol and reduced LDL.
  • Fundus photo #1 – see attached

She presents 18 months later in standard follow-up. Same history, no med changes, BCVA 20/20 OD, OS, OU. Note fundus changes OD Photo #2 vs #1. Seen back in 2 months…photo #3, BCVA 20/20 OD. Seen again 6 months later in follow up photo #4, BCVA 20/25 OD. What do you think is going on and how would you manage? The arrow is pointing to one particular spot on a prominent choroidal vessel in each photo only as a point of reference.

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Alan Glazier
Proud founder of a private practice in the Maryland suburbs of Washington DC. and I founded this small online community called "ODs on Facebook". I like to connect people.

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