A 58-year-old obese woman (BMI = 32 kg/m2) complains of declining visual acuity of 6 months in duration. Physical examination reveals a pulse of 82 per minute, respirations 20 per minute, and blood...

A 58-year-old obese woman (BMI = 32 kg/m2) complains of declining visual acuity of 6 months in duration. Physical examination reveals a pulse of 82 per minute, respirations 20 per minute, and blood pressure 195/110 mm Hg. Funduscopic examination shows “cotton-wool spots,” retinal hemorrhage, “macular star,” edema of the optic nerve, and arteriovenious nicking of retinal arterioles. A photograph of the ocular fundus is shown. These findings are best explained by which of the following mechanisms?

(A) Central retinal artery occlusion

(B) Central retinal vein occlusion

(C) Gangliosidosis

(D) Hypertensive retinopathy

(E) Pigmentary retinopathy