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Susac syndrome — SCE Neurology MCQ

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HardNeurogenetics and NeuroimmunologySusac syndromeSCE Neurology

A patient has the clinical triad of Susac syndrome. Which ophthalmic investigation best documents branch retinal-artery occlusion and characteristic arteriolar-wall leakage?

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Correct answer: A — Wide-field retinal fluorescein angiography documenting branch-artery lesions

The best answer is “Wide-field retinal fluorescein angiography documenting branch-artery lesions”. Retinal fluorescein angiography demonstrates branch retinal-artery occlusions and arteriolar-wall hyperfluorescence, including clinically silent peripheral lesions, and complements audiometry and brain MRI in Susac syndrome. The alternatives “Optical coherence tomography alone without angiographic imaging”, “Visual-evoked potentials to identify optic-nerve demyelination”, “Electroretinography to diagnose a diffuse photoreceptor dystrophy”, “Orbital ultrasound to identify posterior-scleral inflammation” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: National Clinical Guideline for Stroke: acute care: https://www.strokeguideline.org/chapter/acute-care/