Tocilizumab for Silicone Oil-Induced Recalcitrant Cystoid Macular Edema in a Patient with Recurrent Acute Retinal Necrosis-Associated Retinal Detachment.

IF 2.6 4区医学 Q2 OPHTHALMOLOGY

Ocular Immunology and Inflammation Pub Date : 2025-06-18 DOI:10.1080/09273948.2025.2519849

Warren W Pan, Mahsaw Mansoor, David Riccardi, Jacqueline A Madison, Thomas J Wubben, Shilpa Kodati, Jason Miller

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Abstract

Purpose: We report a case of refractory silicone oil-induced cystoid macular edema in a patient with recurrent acute retinal necrosis-related retinal detachments successfully treated with tocilizumab without silicone oil removal nor reactivation of the acute retinal necrosis.

Methods: Single-patient case report.

Results: A monocular patient with recurrent acute retinal necrosis-related retinal detachments necessitating indefinite silicone oil tamponade developed intractable cystoid macular edema immediately after silicone oil placement that was unresponsive to multiple therapies over nearly a year. After a single dose of tocilizumab, the patient demonstrated significant clinical improvement with resolution of the macular edema and reduction in petaloid macular leakage on fluorescein angiography. With continued tocilizumab treatment, silicone oil tamponade could be maintained, and no reactivation of acute-retinal necrosis was noted.

Conclusion: This case represents the first documented successful use of tocilizumab in treating silicone oil-induced recalcitrant cystoid macular edema. When silicone oil cannot be removed from an eye and when steroids risk reactivating viral retinal disease, tocilizumab may offer a safe and effective treatment alternative for such macular edema.

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托珠单抗治疗复发性急性视网膜坏死相关视网膜脱离患者硅油诱导的顽固性囊样黄斑水肿。

目的：我们报告一例难治性硅油诱导的囊样黄斑水肿患者，复发性急性视网膜坏死相关的视网膜脱离，成功地用托珠单抗治疗，没有硅油去除，也没有急性视网膜坏死的重新激活。方法：单例病例报告。结果：一单眼患者复发性急性视网膜坏死相关视网膜脱离，需要不确定硅油填塞，硅油放置后立即发生难治性囊样性黄斑水肿，多次治疗无效近一年。单剂量tocilizumab后，患者表现出显著的临床改善，黄斑水肿消退，荧光素血管造影显示花瓣状黄斑渗漏减少。继续托珠单抗治疗，硅油填塞可以维持，没有发现急性视网膜坏死的再激活。结论：该病例代表了首次成功使用托珠单抗治疗硅油诱导的顽固性囊样黄斑水肿。当硅油不能从眼睛中取出时，当类固醇有重新激活病毒性视网膜疾病的风险时，托珠单抗可能为这种黄斑水肿提供安全有效的治疗选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ocular Immunology and Inflammation 医学-眼科学

CiteScore

6.20

自引率

15.20%

发文量

285

审稿时长

6-12 weeks

期刊介绍： Ocular Immunology & Inflammation ranks 18 out of 59 in the Ophthalmology Category.Ocular Immunology and Inflammation is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and vision scientists. Published bimonthly, the journal provides an international medium for basic and clinical research reports on the ocular inflammatory response and its control by the immune system. The journal publishes original research papers, case reports, reviews, letters to the editor, meeting abstracts, and invited editorials.