EyeNet Magazine
  February 2004  
  Feature Story  
  Ocular Allergies: Fight the Mite  
  Clinical Insights  
  Genetic Tests: High Hopes vs. Reality  
  Journal Highlights  
  Detecting the Ocular Ischemic Syndrome  
  Laser Spot Size: Is Smaller Better?  
  Managing Ocular Toxoplasmosis  
  Morning Rounds  
  What's your diagnosis?  
  Blink Mystery Image  
  Practice Management  
  Savvy Coder  
  Practice Perfect  
  News in Review  
  Products & Services  
  On Procrastination  


Eneil Simpson, Ophthalmic Photographer,
Mount Sinai School of Medicine, NY

The answer to this month’s mystery image: 

Susac's Syndrome
The 32-year-old patient presented with peripheral musculoskeletal weakness. An MRI and eye exam revealed white matter lesions and a cotton-wool spot in the left eye. Despite treatment with corticosteroids, she continued to experience microinfarcts and then complained of decreased vision and loss of hearing on the right side. Dilated fundoscopy and fluorescein angiography exposed branch retinal artery occlusion in both fundi. (The patient's left eye is shown in these two images.)

The ophthalmologist recognized this clinical combination as typical of Susac's syndrome, a condition believed to be of autoimmune etiology, that usually affects women between the ages of 20 and 40.

The patient was started on intravenous immunoglobulin treatment. Upon further follow-up, her condition markedly improved and her vision returned to normal.
Blink is edited by Richard E. Hackel, MA, CRA

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