Brain fog and vessel clogs.

Area of Science:

• Ophthalmology
• Neurology
• Vascular Medicine

Background:

• Susac syndrome (SS) is a rare autoimmune condition characterized by the triad of encephalopathy, branch retinal artery occlusions (BRAOs), and sensorineural hearing loss.
• While typically affecting young women, SS can present with varied and sometimes atypical features, posing diagnostic challenges.

Observation:

• A 36-year-old female presented with symptoms indicative of bilateral retinal vascular occlusion, hearing loss, and encephalopathy.
• Comprehensive ocular examinations, including wide-field fundus photography, OCT, and FA, were performed.
• Systemic investigations were conducted in conjunction with neurological and otological consultations.

Findings:

• The patient was diagnosed with Susac syndrome (SS).
• The case highlights a rare presentation of combined bilateral retinal vascular occlusion in the context of SS.
• Treatment involved laser photocoagulation and pars plana vitrectomy.

Implications:

• This case underscores the importance of considering SS in patients with the characteristic triad, even with atypical vascular findings.
• Early diagnosis and multimodal treatment are crucial for managing SS and preventing vision and neurological deficits.
• Further research into the pathogenesis and optimal management strategies for rare SS variants is warranted.