Purpose: To report maculopathy associated with the long-term use of fondaparinux. a heparin mimetic and inhibitor of the extracellular matrix enzyme. heparanase. Observations: A 41-year-old woman receiving thrice weekly injections of fondaparinux as prophylaxis against deep vein thrombosis for 9 years noticed gray spots in her vision without metamorphopsias. https://www.ealisboa.com/limited-value-AXYS-Valhalla-Pen-must-buy/