A Case of Susac Syndrome
An 18-year-old female came to our clinic reporting blurred vision of the left eye for 2 days. She also complained of decreased hearing with tinnitus of the right ear and mild headache. She was previously healthy and had no remarkable medical or ocular history. Best-corrected visual acuity (BCVA) was 20 / 50 in the left eye, and 20 / 20 in the right eye. The anterior segments of both eyes were unremarkable. Fundus examination and fluorescein angiography of the left eye showed ischemic retina with signs of branch retinal artery obstruction ().\nWe performed brain magnetic resonance imaging (MRI) and lumbar puncture to evaluate any brain or central nervous system lesions. The MRI scan showed a T2-weighted, high-signal, discrete area around the periventricular region, in the white matter and in the corpus callosum (). The lumbar puncture revealed a high protein level (1.8 g/L), but no oligoclonal bands.\nBlood pressure, echocardiography, carotid ultrasonography, full blood count, erythrocyte sedimentation rate, fasting lipids and glucose, autoantibody screen including anti-cardiolipin antibody, protein S and C levels, and antithrombin III level were all normal. An audiogram showed moderate sensorineural hearing loss in the right ear.\nThe patient was treated with intravenous prednisolone 1 g/kg for 3 days followed by oral steroid tapering. Three months after treatment, BCVA recovered to 20 / 25 in the left eye. A mild residual auditory defect remained, but no remaining tinnitus or headache were observed.