Bilateral Branch Retinal Artery Occlusions Research Articles

The Spectrum of Isolated Retinal Artery Occlusion Secondary to Giant Cell Arteritis.

We systematically reviewed the literature to investigate the clinical features of isolated arteritic retinal artery occlusion (A-RAO) associated with giant cell arteritis (GCA). The four primary types of A-RAO were central retinal artery occlusion (CRAO), hemi-central retinal artery occlusion (hCRAO), branch retinal artery occlusion (BRAO), and cilioretinal artery occlusion (CLRAO). The most reported presentation was unilateral CRAO, followed by bilateral CRAO, unilateral CLRAO, and bilateral BRAO. Most RAOs were accompanied by typical GCA signs and symptoms, which can help distinguish them from non-arteritic RAOs. When reported, temporal artery biopsy confirmed GCA in most cases. Patients with GCA may present with a broad spectrum of isolated unilateral and bilateral A-RAOs. [Ophthalmic Surg Lasers Imaging Retina 2024;55:536-540.].

Involuntary crying episodes with Susac\u2019s syndrome\u2014a rare presentation of a rare disease: a case report

BackgroundIn this case, we reported the pseudobulbar affect (PBA) in a patient with Susac’s syndrome—a rare condition that was caused by a rare syndrome. Previous case reports of Susac syndrome described psychiatric symptoms such as emotional disturbances or personality changes. Only a few case reports have reported psychiatric disorders in patients with Susac’s syndrome. There were no reported cases of Susac syndrome with PBA as an initial presentation.Case presentationOur patient was 56 years old and presented with involuntary crying, left-sided headache, left-sided hearing loss, and tinnitus. Brain MRI showed numerous areas of restricted diffusion and enhancement involving the corpus callosum, bilateral hemispheres, and brainstem. Ophthalmological evaluation showed bilateral branch retinal artery occlusion. She was diagnosed with Susac’s syndrome and PBA. She was treated with cyclophosphamide and dextromethorphan hydrobromide/quinidine sulfate with excellent recovery. This is a 2-year clinical course.Discussion and conclusionsRecognition of the clinical presentation of Susac’s syndrome and PBA with early diagnosis and treatment are the keys to preventing further disability and impact on patients and their families.

A case of susac syndrome.

A 32-year-woman presented with mild encephalopathy, unsteady gait and instability, history of bilateral deafness, and bilateral visual changes. Magnetic resonance imaging of the brain demonstrated multiple hyperintensities involving the corpus callosum (Figure 1). There was no cord signal abnormality on imaging studies of the spinal cord. Imaging studies of the cervical and intracranial vasculature showed no evidence of vasculitis. Cerebrospinal fluid markers for inflammation and demyelination were negative, including oligoclonal bands. Visual evoked potentials were within normal limits. Extensive laboratory testing including Lyme antibody titers was unremarkable. Ophthalmology referral confirmed bilateral branch retinal artery occlusions. The patient was also referred for audiography evaluation, which confirmed bilateral hearing loss. These symptoms, retinal and audiographic examination, and imaging study findings were consistent with a diagnosis of Susac syndrome. Susac syndrome is an immune-mediated endotheliopathy characterized by the triad of encephalopathy, cochlear hearing loss, and retinal artery occlusions diagnosed by clinical examination supported by pathognomonic corpus callosum involvement on magnetic resonance imaging.1 The patient was initially treated with corticosteroids, but these were discontinued following resolution of symptoms, as Susac syndrome is a self-limiting condition. Should she experience recurrence of symptoms, options for therapy include a combination of immunosuppressive agents such as corticosteroids, intravenous immunoglobulin, methotrexate, mycophenolate, and cyclosphosphamide.2 Figure 1. Magnetic resonance imaging (MRI) of brain T2 fluid-attenuated inverted recovery (FLAIR) demonstrating multiple hyperintensities involving the corpus callosum.

Oclusão de ramo arterial retiniano bilateral

The authors report a case of a patient who presented bilateral branch retinal artery occlusion without any meaningful systemic underlying conditions. The authors report a case of a patient who presented bilateral branch retinal artery occlusion without any meaningful systemic underlying conditions.

Recurrent Bilateral Branch Retinal Artery Occlusion with Hearing Loss and Encephalopathy: The First Case Report of Susac Syndrome in Korea

We report the first case of Susac syndrome in Koreans, in a 23-yr-old female patient who presented with sudden visual loss and associated neurological symptoms. Ophthalmic examination and fluorescein angiography showed multiple areas of branch retinal artery occlusion, which tended to recur in both eyes. Magnetic resonance imaging showed dot-like, diffusion-restricted lesions in the corpus callosum and left fornix, and audiometry showed low-frequency sensory hearing loss, compatible with Susac syndrome. She received immunosuppressive therapy with oral steroid and azathioprine. Three months later all the symptoms disappeared but obstructive vasculitis have been relapsing. This patient demonstrated the entire clinical triad of Susac syndrome, which tends to occur in young females. Although this disorder has rarely been reported in Asian populations, a high index of suspicion is warranted for early diagnosis and timely treatment.

Protein S Deficiency and Bilateral Branch Retinal Artery Occlusion

A macular branch retinal artery occlusion developed in the right eye of a 25-year-old woman when she was 38 weeks pregnant. She subsequently presented 5 days postpartum with a branch retinal artery occlusion in her left eye. Although her initial work-up did not reveal a source for her occlusions, subsequent studies have documented a deficiency of protein S.