Tocilizumab for Cystoid Macular Edema Secondary to Immune Recovery Uveitis in a Patient with Contraindications to Long-Term Systemic Corticosteroid

• DOI: 10.59249/nqrt7239
• Publication Date: 2024-12-20T08:00:15Z
• Authors: Ba Trung Nguyen; Jia-Horung Hung; Zheng Xian Thng; Dalia El Feky; Azadeh Mobasserian; Aim-On Saengsirin...; Xiaoyan Zhang; Frances Andrea An...; S. Saeed Mohammadi; Ngoc Tuong Trong ...; Anadi Khatri; Negin Yavari; Battuya Ganbold; Cigdem Yasar; Osama Elaraby; Amir Akhavanrezayat; Woong-Sun Yoo; Ankur Sudhir Gupta; Quan Dong Nguyen
• Keywords: Foscarnet; Tocilizumab; Cytomegalovirus retinitis; Systemic vasculitis

Purpose: To report a case of cystoid macular edema (CME) secondary to immune recovery uveitis (IRU) in patient with previous history cytomegalovirus (CMV) retinitis and leukemia, which was successfully treated tocilizumab (TCZ), an interleukin-6 (IL-6) receptor antagonist. Method: The clinical records the were reviewed, focusing on demographics, image findings, course. Results: A 17-year-old female past medical T-cell acute lymphoblastic leukemia (T-ALL) undergoing chemotherapy for two years presented active CMV retinitis. She intravitreal foscarnet injections systemic ganciclovir. After 5 months valganciclovir maintenance following cessation chemotherapy, developed bilateral CME vasculitis, diagnosed IRU. management challenging due avascular necrosis femoral head resulting from prolonged corticosteroid use. Two cycles monthly TCZ infusions administered at dosage 8mg/kg. Subsequently, retinal vasculitis resolved significantly without any evidence inflammation anterior chamber vitreous. Conclusion: index demonstrated safety efficacy IL-6 antagonist treating associated IRU non-HIV patient.