A Case Report of Using Intravitreal Dexamethasone Implants as the Bridging Treatment for Ocular Manifestations in Susac Syndrome.

PURPOSE: To report a case of successful bridging treatment for ocular manifestations of Susac syndrome using intravitreal dexamethasone implants.

METHODS

Observational case report and review of literature.

RESULTS

A 31-year-old woman initially presented with refractory headache and confusion. Despite ongoing aggressive immunosuppressive therapies for non-infectious cerebral vasculitis, she continued to develop bilateral hearing loss and branch retinal artery occlusion in the left eye. Fluorescein angiography showed characteristic arteriolar wall hyperfluorescence in both eyes, compatible with active Susac syndrome. While additional immunosuppressive treatments were delayed, the patient received bilateral intravitreal dexamethasone implants. The following fluorescein angiography demonstrated full resolution of arteriolar wall hyperfluorescence in both eyes. After ocular treatments, systemic therapies were modified with the addition of monthly intravenous immunoglobin infusion.

CONCLUSION

In cases of delayed systemic immunosuppressive therapies, intravitreal dexamethasone can be considered as a bridging treatment for ocular manifestations of Susac syndrome.