Review Question - QID 210625

A 55-year-old African-American man presents to his primary care physician for a general check-up. The patient states that he feels well aside from the occasional headache. He also reports trouble maintaining an erection with his new girlfriend. The patient has a past medical history of diabetes, hypertension, and vascular claudication. His temperature is 99.1°F (37.3°C), blood pressure is 187/108 mmHg, pulse is 90/min, respirations are 15/min, and oxygen saturation is 99% on room air. A physical exam is notable for narrowing of the patient's visual field. The rest of his neurological exam is within normal limits. An ophthalmoscopic exam reveals the finding in Figure A. Which of the following is the most likely diagnosis?