Appearance and resolution of numerous bilateral gass plaques in probable Susac syndrome.

Publication Title

Am J Ophthalmol Case Rep

Document Type

Article

Publication Date

12-1-2024

Keywords

oregon; medford

Abstract

PURPOSE: To describe a patient with a unique retinal phenotype of probable Susac syndrome.

OBSERVATIONS: A 47-year-old female who presented with bilateral tinnitus and vision changes was found to have bilateral sensorineural hearing loss and many bilateral retinal arteriolar Gass plaques. She had bilateral scotomas corresponding with temporal thinning and atrophy of the inner nuclear layer (INL) on OCT. Retinal examination and fluorescein angiography demonstrated minimal arteriolar wall hyperfluorescence with no evidence of acute branch retinal artery occlusion. She developed daily headaches. MRI of the brain was normal with no corpus callosal lesions. She was diagnosed with probable Susac syndrome based on the above findings.

CONCLUSIONS AND IMPORTANCE: Our patient's bilateral high frequency sensorineural hearing loss, numerous bilateral Gass plaques, and headaches are most likely attributable to Susac syndrome. While BRAO is considered a cornerstone of retinal involvement in Susac syndrome, it may only be appreciable angiographically in the acute setting, and it is important to recognize Gass plaques as a significant diagnostic marker of disease.

Clinical Institute

Neurosciences (Brain & Spine)

Specialty

Neurosciences

Specialty

Ophthalmology

Specialty

Neurosciences

DOI

10.1016/j.ajoc.2024.102088

Link to Full Text

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