Evidence map›Paper›PMID 32875161›Full record

ArticleAmerican journal of ophthalmology case reports2020

Anti-interleukin-6 receptor therapy with tocilizumab for refractory pseudophakic cystoid macular edema.

Brandon Huy Pham, Doan Luong Hien, Wataru Matsumiya, Than Trong Tuong Ngoc, Huy Luong Doan, Amir Akhavanrezayat, Çigdem Yaşar, Huy Vu Nguyen, Muhammad Sohail Halim, Quan Dong Nguyen

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of ophthalmology case reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Tocilizumab for cystoid macular edema secondary to retinitis pigmentosa.Journal of ophthalmic inflammation and infection · 2024
    Article
  2. Interleukin-6 and Macular Edema: A Review of Outcomes with Inhibition.International journal of molecular sciences · 2023
    Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Brandon Huy PhamByers Eye Institute, Stanford University, Palo Alto, CA, USA.
Doan Luong HienByers Eye Institute, Stanford University, Palo Alto, CA, USA.
Wataru MatsumiyaByers Eye Institute, Stanford University, Palo Alto, CA, USA.
Than Trong Tuong NgocByers Eye Institute, Stanford University, Palo Alto, CA, USA.
Huy Luong DoanKansas City University of Medicine and Biosciences, Kansas City, MO, USA.
Amir AkhavanrezayatByers Eye Institute, Stanford University, Palo Alto, CA, USA.
Çigdem YaşarByers Eye Institute, Stanford University, Palo Alto, CA, USA.
Huy Vu NguyenByers Eye Institute, Stanford University, Palo Alto, CA, USA.
Muhammad Sohail HalimByers Eye Institute, Stanford University, Palo Alto, CA, USA.
Quan Dong NguyenByers Eye Institute, Stanford University, Palo Alto, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo describe the clinical course of a patient with refractory pseudophakic cystoid macular edema treated with interleukin-6 receptor antagonist tocilizumab. OBSERVATIONS: An 80-year-old Caucasian man with past ocular history significant for glaucoma (right eye) and iritis presented with cystoid macular edema (CME) in the right eye (OD). His ocular surgery history was significant for cataract extraction with posterior chamber intraocular lenses in 1999 and YAG laser capsulotomy in 2014 in both eyes (OU). His medications at time of presentation included latanoprost and dorzolamide-timolol in OD for glaucoma, as well as prednisolone in OD for iritis. Upon examination, his visual acuity was 20/250 in OD and 20/20 in the left eye (OS). Intraocular pressure was 20 mmHg in OD and 10 mmHg in OS. Slit-lamp examination revealed no cells or flare in OU. Dilated fundus exam showed CME and a cup-to-disk ratio of 0.9 in OD and normal findings in OS. Initial spectral domain optical coherence tomography (SD-OCT) demonstrated intraretinal fluid in both outer and inner layers as well as mild subretinal fluid with an intact ellipsoid zone in OD. Fluorescein angiography revealed perifoveal leakage in OD. Laboratory evaluations, including infectious work-up, were unremarkable. While the patient's CME initially improved after initiation of therapy with topical prednisolone and oral acetazolamide, the CME later recurred after systemic acetazolamide was stopped due to intolerable side effects. Despite multiple therapeutic approaches, including topical and systemic corticosteroids (both oral and intravenous) and topical interferon α2b over the course of more than one year, the patient's visual acuity continued to worsen with increasing intra- and subretinal fluid in the macula. Due to the refractory CME, the patient was started on monthly infusions of anti-interleukin (IL)-6 receptor tocilizumab (8 mg/kg) with three days of methylprednisolone infusions (500 mg/day). After nine cycles of treatment, SD-OCT demonstrated restoration of normal foveal contour with complete resolution of CME. CONCLUSIONS AND IMPORTANCE: IL-6 inhibition with tocilizumab may be a safe and effective treatment for refractory CME. Further studies are needed to elucidate the nature and extent of therapeutic IL-6 inhibition in CME.

Indexed as

Cataract surgeryInterleukin-6 inhibitionIrvine-gass syndromeMacular edemaTocilizumab

Identifiers

PMID32875161
PMCPMC7452126

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.