Pan Warren W, Mansoor Mahsaw, Riccardi David, Madison Jacqueline A, Wubben Thomas J, Kodati Shilpa, Miller Jason
Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA.
Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Ocul Immunol Inflamm. 2025 Jun 18:1-4. doi: 10.1080/09273948.2025.2519849.
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.
Single-patient case report.
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.
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.
我们报告一例难治性硅油诱导的黄斑囊样水肿病例，该患者患有复发性急性视网膜坏死相关的视网膜脱离，成功接受了托珠单抗治疗，未进行硅油取出，急性视网膜坏死也未复发。
单病例报告。
一名单眼患者患有复发性急性视网膜坏死相关的视网膜脱离，需要长期硅油填充，在硅油填充后立即出现难治性黄斑囊样水肿，近一年来对多种治疗均无反应。单次注射托珠单抗后，患者临床症状显著改善，黄斑水肿消退，荧光素血管造影显示花瓣样黄斑渗漏减少。继续使用托珠单抗治疗后，硅油填充得以维持，未发现急性视网膜坏死复发。
本病例是首次有记录的成功使用托珠单抗治疗硅油诱导的顽固性黄斑囊样水肿。当无法从眼中取出硅油且使用类固醇有激活病毒性视网膜疾病的风险时，托珠单抗可能为此类黄斑水肿提供一种安全有效的治疗选择。
