Review Question - QID 109571

A 55-year-old man comes to the clinic for a follow-up visit. He has a long history of diabetes mellitus and recently had his diabetic screening exams (including a hemoglobin A1c of 7.2%), a normal foot examination, and normal lipid levels. Although he failed metformin and sulfonylurea therapy, the patient's diabetes is now well-controlled with glargine and insulin lispro. The patient states that he still drives and can see highway billboards and signs without trouble. He rarely reads, opting to spend his early retirement playing golf. During the patient's eye exam 1 month ago, the ophthalmologist's fundoscopic examination revealed scattered bright yellow drusen seen in Figure A. Visual examination today is 20/40 OD (right eye) and 20/40 OS (left eye). His temperature is 98.7°F (37°C), blood pressure is 120/70 mmHg, pulse is 90/min, and respirations are 15/min. 2 years ago, his visual acuity was 20/20 in both eyes. He states that he just has dry eyes and needs to blink several times in order to get a perfect visual exam score. He denies any floaters, diplopia, or blurred vision. What is the most likely diagnosis?