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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