05/07/2026
A rare diagnosis uncovered through careful clinical investigation.
A patient presenting with flu-like symptoms, severe headache, and sudden visual field loss was initially found to have a branch retinal artery occlusion and multifocal white matter infarcts on MRI. As visual symptoms progressed and hearing loss developed, repeat imaging revealed corpus callosum lesions. Fluorescein angiography showed arterial wall hyperfluorescence in the left eye — a key clue leading to the diagnosis of Susac syndrome. With the classic triad of branch retinal artery occlusion, hearing loss, and encephalopathy, the patient was treated with rituximab, steroids, and IVIG. At follow-up, vision remained 20/20 with a stable residual scotoma. This case highlights the importance of recognizing subtle ophthalmic findings that can reveal complex systemic disease.
Case by: Dr. Kisha Kalra and Dr. Thomas Albini