{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T04:12:57Z","timestamp":1745467977590,"version":"3.40.4"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"5-6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,23]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Susac syndrome can resemble various disorders resulting in a delayed or missed diagnosis and subsequent delays in treatment. Here, we present how successful consideration of patient history, symptoms, and ancillary testing led to prompt diagnosis and treatment of Susac syndrome by ophthalmologists. A 27-year-old active duty infantryman presented with sudden vision loss in the right eye during strenuous exercise after experiencing similar symptoms in the left eye 5 months earlier. The patient\u2019s medical history was notable for mixed conductive and sensorineural hearing loss, confounded by a history of concussions, syncope, frequent ear infections, tympanic membrane perforation requiring tympanoplasty, and loud noise exposures. Identification of branch retinal artery occlusions on fluorescein angiography and low-to-mid frequency hearing loss confirmed the diagnosis of Susac syndrome. The patient was immediately treated with high-dose oral prednisone and subsequently transitioned to rituximab infusions to preserve vision. Susac syndrome should be considered when a patient presents with vision loss, hearing deficits, and or cognitive changes, even if symptoms are separated by time and seemingly attributed to more common causes.<\/jats:p>","DOI":"10.1093\/milmed\/usaf015","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T16:10:16Z","timestamp":1738339816000},"page":"1300-1305","source":"Crossref","is-referenced-by-count":0,"title":["Vision Loss in an Infantryman With Complex Hearing Loss: Case Report and Review of Susac Syndrome"],"prefix":"10.1093","volume":"190","author":[{"given":"Lester H","family":"Lambert","sequence":"first","affiliation":[{"name":"Medical Department, Marine Air Support Squadron-3, Marine Air Control Group-38, Third Marine Aircraft Wing, First Marine Expeditionary Force , 32874 Macs Road, Camp Pendleton, CA 92058,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline J","family":"Kernan","sequence":"additional","affiliation":[{"name":"Department of Graduate Medical Education, Naval Medical Center San Diego , 34800 Bob Wilson Drive, San Diego, CA 92134,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn M","family":"Hartmann","sequence":"additional","affiliation":[{"name":"Radiology Department, Naval Hospital Camp Pendleton , 200 Mercy Cir, Camp Pendleton, CA 92055,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen R","family":"O\u2019Connell","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, Naval Hospital Camp Pendleton , 200 Mercy Circle, Camp Pendleton, CA 92055,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7952-7344","authenticated-orcid":false,"given":"Brittany E","family":"Powell","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Naval Medical Center San Diego , 34800 Bob Wilson Dr, Suite 202, San Diego, CA 92134,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,1,31]]},"reference":[{"issue":"6","key":"2025042308421299100_R1","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1038\/nrneurol.2013.82","article-title":"Characteristics of Susac syndrome: a review of all reported cases","volume":"9","author":"Dorr","year":"2013","journal-title":"Nat Rev Neurol."},{"issue":"15","key":"2025042308421299100_R2","doi-asserted-by":"publisher","first-page":"12137","DOI":"10.18632\/oncotarget.24343","article-title":"Synergistic neuroprotective effect of rasagiline and idebenone against retinal ischemia-reperfusion injury via the Lin28-let-7-Dicer pathway","volume":"9","author":"Lei","year":"2018","journal-title":"Oncotarget"},{"issue":"9","key":"2025042308421299100_R3","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1080\/00207454.2016.1254631","article-title":"Susac\u2019s syndrome: clinical course and epidemiology in a Central European population","volume":"127","author":"Seifert-Held","year":"2017","journal-title":"Int J Neurosci"},{"issue":"3","key":"2025042308421299100_R4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2007.06.007","article-title":"Susac\u2019s syndrome presenting with consciousness disturbance","volume":"19","author":"Li","year":"2008","journal-title":"Eur J Intern Med."},{"issue":"2","key":"2025042308421299100_R5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0229068","article-title":"Safety and effectiveness of a novel neuroprotectant, KUS121, in patients with non-arteritic central retinal artery occlusion: an open-label, non-randomized, first-in-humans, phase 1\/2 trial","volume":"15","author":"Ikeda","year":"2020","journal-title":"PLoS One"},{"key":"2025042308421299100_R6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/bcr-2017-220200","article-title":"Urodynamic findings in Susac syndrome: first reported filling cystometrogram","volume":"2017","author":"Nzenza","year":"2017","journal-title":"BMJ Case Rep."},{"issue":"1","key":"2025042308421299100_R7","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1097\/WNO.0000000000000677","article-title":"Diagnostic criteria and treatment algorithm for Susac syndrome","volume":"39","author":"Egan","year":"2019","journal-title":"J Neuroophthalmol"},{"issue":"4","key":"2025042308421299100_R8","doi-asserted-by":"publisher","first-page":"374","DOI":"10.4103\/jpn.JPN_128_17","article-title":"Susac\u2019s syndrome (retinocochleocerebral vasculopathy): follow-up of a pediatric patient","volume":"12","author":"Karalok","year":"2017","journal-title":"J Pediatr Neurosci"},{"issue":"7","key":"2025042308421299100_R9","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1007\/s00247-007-0492-3","article-title":"Susac syndrome in a young child","volume":"37","author":"Eluvathingal Muttikkal","year":"2007","journal-title":"Pediatr Radiol."},{"issue":"3","key":"2025042308421299100_R10","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1016\/j.neurol.2023.09.003","article-title":"Early treatment with rituximab in Susac syndrome","volume":"180","author":"Mazloum","year":"2024","journal-title":"Revue Neurologique"},{"key":"2025042308421299100_R11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1742-2094-11-46","article-title":"Clinical, paraclinical and serological findings in Susac syndrome: an international multicenter study","volume":"11","author":"Jarius","year":"2014","journal-title":"J Neuroinflammation"},{"issue":"1","key":"2025042308421299100_R12","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1097\/mao.0b013e31818b6ac2","article-title":"Susac syndrome\u2014a report of cochlear implantation and review of otologic manifestations in twenty-three patients","volume":"30","author":"Roeser","year":"2009","journal-title":"Otol Neurotol."},{"issue":"6","key":"2025042308421299100_R13","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1080\/01913123.2019.1692117","article-title":"Brain microvascular pathology in Susac syndrome: an electron microscopic study of five cases","volume":"43","author":"Agamanolis","year":"2019","journal-title":"Ultrastruct Pathol."},{"issue":"1","key":"2025042308421299100_R14","doi-asserted-by":"publisher","DOI":"10.1007\/s11940-015-0386-x","article-title":"Treatment of Susac syndrome","volume":"18","author":"Vodopivec","year":"2016","journal-title":"Curr Treat Options Neurol."},{"issue":"6","key":"2025042308421299100_R15","doi-asserted-by":"publisher","first-page":"1771","DOI":"10.1111\/ene.15317","article-title":"Diagnosis, differential diagnosis and misdiagnosis of Susac syndrome","volume":"29","author":"Triplett","year":"2022","journal-title":"Eur J Neurol."},{"issue":"3","key":"2025042308421299100_R16","first-page":"50","article-title":"Retinal blood-flow velocity and oximetry status monitoring in a central retinal vein occlusion patient","volume":"6","author":"Jittpoonkuson","year":"2009","journal-title":"Retin Physician"},{"issue":"8","key":"2025042308421299100_R17","doi-asserted-by":"publisher","first-page":"814","DOI":"10.1016\/j.autrev.2014.04.004","article-title":"Susac\u2019s syndrome\u2014pathogenesis, clinical variants and treatment approaches","volume":"13","author":"Greco","year":"2014","journal-title":"Autoimmun Rev."},{"key":"2025042308421299100_R18","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.msard.2019.05.018","article-title":"Susac syndrome: clinical characteristics, diagnostic findings and treatment in 19 cases","volume":"33","author":"Zengin Karahan","year":"2019","journal-title":"Mult Scler Relat Disord."},{"issue":"1","key":"2025042308421299100_R19","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1111\/ene.15062","article-title":"Brain magnetic resonance imaging lesion load at diagnosis, severity at onset and outcomes in Susac syndrome: a prospective cohort study","volume":"29","author":"Scheifer","year":"2022","journal-title":"Eur J Neurol."},{"issue":"12","key":"2025042308421299100_R20","doi-asserted-by":"publisher","first-page":"5719","DOI":"10.1007\/s00415-023-11936-3","article-title":"Clinical characteristics and treatment approaches in patients with Susac syndrome: a scoping review of cases","volume":"270","author":"Stinissen","year":"2023","journal-title":"J Neurol."},{"key":"2025042308421299100_R21","doi-asserted-by":"publisher","DOI":"10.1038\/srep05970","article-title":"Novel VCP modulators mitigate major pathologies of rd10, a mouse model of retinitis pigmentosa","volume":"4","author":"Ikeda","year":"2014","journal-title":"Sci Rep."},{"key":"2025042308421299100_R22","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1339438","article-title":"Case report: Susac syndrome-two ends of the spectrum, single center case reports and review of the literature","volume":"15","author":"Cvikova","year":"2024","journal-title":"Front Neurol."},{"issue":"6","key":"2025042308421299100_R23","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1309\/AJCPERI7LC4VNFYK","article-title":"Susac syndrome: an organ-specific autoimmune endotheliopathy syndrome associated with anti-endothelial cell antibodies","volume":"136","author":"Magro","year":"2011","journal-title":"Am J Clin Pathol."},{"issue":"6","key":"2025042308421299100_R24","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1093\/jnen\/nlz031","article-title":"Neuropathological findings in Susac syndrome: an autopsy report","volume":"78","author":"Agamanolis","journal-title":"J Neuropathol Exp Neurol"},{"key":"2025042308421299100_R25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.33425\/2832-4226\/21016","article-title":"Rare case of Susac syndrome","volume":"6","author":"Ekladious","year":"2021","journal-title":"Am J Med"},{"issue":"3","key":"2025042308421299100_R26","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000200209","article-title":"Clinical characterization and ancillary tests in Susac syndrome: a systematic review","volume":"11","author":"Wilf-Yarkoni","year":"2024","journal-title":"Neurol Neuroimmunol Neuroinflamm."},{"issue":"1","key":"2025042308421299100_R27","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-020-01892-0","article-title":"Increased incidence of Susac syndrome: a case series study","volume":"20","author":"Wilf-Yarkoni","journal-title":"BMC Neurol."},{"issue":"43","key":"2025042308421299100_R28","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000005223","article-title":"Susac syndrome: clinical characteristics, clinical classification, and long-term prognosis","volume":"95","author":"Vishnevskia-Dai","year":"2016","journal-title":"Medicine (Baltimore)"},{"issue":"6","key":"2025042308421299100_R29","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2022.103097","article-title":"Susac syndrome: a scoping review","volume":"21","author":"David","year":"2022","journal-title":"Autoimmun Rev."}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/190\/5-6\/1300\/61720844\/usaf015.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/190\/5-6\/1300\/61720844\/usaf015.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T12:42:20Z","timestamp":1745412140000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/190\/5-6\/1300\/7994251"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,31]]},"references-count":29,"journal-issue":{"issue":"5-6","published-online":{"date-parts":[[2025,1,31]]},"published-print":{"date-parts":[[2025,4,23]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usaf015","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"type":"print","value":"0026-4075"},{"type":"electronic","value":"1930-613X"}],"subject":[],"published-other":{"date-parts":[[2025,5]]},"published":{"date-parts":[[2025,1,31]]}}}