▁such ▁as ▁dense ▁h yal ine ▁material ▁surrounding ▁end om ys ial ▁cap ill aries . ▁This ▁suggests ▁a ▁possible ▁system ic ▁component ▁of ▁this ▁disease , ▁despite ▁the ▁pre domin ance ▁of ▁central ▁nerv ous ▁system ▁features . ▁ ▁The ▁latest ▁thinking ▁is ▁that ▁an ▁ant ib ody ▁directed ▁against ▁end oth el ial ▁cells ▁is ▁the ▁path ogen ic ▁mechanism ▁in ▁this ▁disease ▁which ▁causes ▁the ▁micro scop ic ▁stro kes ▁in ▁the ▁brain , ▁ret ina , ▁and ▁inner ▁ear . ▁ ▁Di agn osis ▁Pat ients ▁typically ▁present ▁with ▁low ▁frequency ▁hearing ▁loss ▁detect able ▁via ▁an ▁audi ogram . ▁ ▁Head aches ▁are ▁frequently ▁present ▁in ▁addition ▁to ▁ro aring ▁t inn it us ▁and ▁often ▁some ▁degree ▁of ▁par ano ia . ▁ ▁Part ial ▁vision ▁loss ▁is ▁often ▁present ▁and ▁caused ▁by ▁branch ▁ret inal ▁ar tery ▁occ lus ions . ▁ ▁The ▁presence ▁of ▁ref ract ile ▁or ▁non - ref ract ile ▁yellow ▁G ass ▁pla ques ▁in ▁the ▁ret inal ▁ar ter i oles ▁is ▁near ▁path ogn om onic ▁for ▁the ▁disease . ▁ ▁Fl u ores ce in ▁ang i ography ▁may ▁demonstrate ▁leak age ▁in ▁areas ▁remote ▁from ▁the ▁ret inal ▁inf ar ctions . ▁ ▁Rad i ographic ▁appearance ▁In ▁a ▁recent ▁analysis ▁( S us ac ▁et ▁al ., ▁ 2 0 0 3 ), ▁M RI ▁images ▁from ▁ 2 7 ▁patients ▁ful fill ing ▁the ▁di agnostic ▁criteria ▁of ▁Sus ac ' s ▁synd rome ▁were