An 85-year-old male experiences sudden vision loss with visual disturbances. Which condition is least likely to be included in the differential diagnosis?

The condition that is least likely to be included in the differential diagnosis for sudden vision loss with visual disturbances in an 85-year-old male is diabetic retinopathy. Diabetic retinopathy typically develops over time as a complication of diabetes, leading to gradual vision changes rather than acute or sudden vision loss.

In elderly patients, sudden vision loss is more frequently associated with conditions such as retinal detachment, which can occur suddenly and is characterized by the immediate onset of visual disturbances. Transient Ischemic Attacks (TIAs) can also present with sudden visual loss and other neurological symptoms due to transient disruptions in blood flow to the brain, impacting visual processing. Ophthalmic migraines may cause temporary visual disturbances including scotomas or flashes of light, and while they may not be as common in older adults, they can result in acute episodes.

Thus, the other conditions are more aligned with the acute presentation of the patient’s symptoms, while diabetic retinopathy’s chronic nature makes it less likely to be the direct cause of sudden vision loss in this scenario.