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.
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Blink is edited by Richard E. Hackel, MA, CRA