A 65-year-old white woman presented with 9 months of intermittent “kaleidoscopic” visual disturbances and blurred vision upon awakening.
Her medical history was significant for hypertension, hyperlipidemia, transient ischemic attack, peripheral arterial disease, bilateral anterior circulation ischemic strokes, postural hypotension, left carotid artery stenosis and stenting, papillary thyroid carcinoma treated with radical neck dissection, thyroidectomy and radiation at age 15 years, and breast cancer treated with lumpectomy and radiation. Her medications included clopidogrel, levothyroxine,