PURPOSE: To demonstrate improvement and stabilization of retinal findings, 
including recalcitrant cystoid macular edema, in a patient with 
nonparaneoplastic autoimmune retinopathy after treatment with tocilizumab, a 
humanized monoclonal antibody against soluble and membrane-bound IL-6 receptor.
METHODS: Observational case report. A 46-year-old woman was diagnosed with 
nonparaneoplastic autoimmune retinopathy and followed over 4 years on various 
immunosuppressive medications with worsening disease and recalcitrant cystoid 
macular edema. This report describes the rapid improvement and stabilization of 
her ocular disease once tocilizumab was initiated.
RESULTS: Tocilizumab, a monoclonal antibody against the IL-6 receptor, was 
initiated at a dose of 8 mg/kg every 4 weeks. Cystoid macular edema was 
significantly decreased after just two infusions and nearly resolved after five 
infusions. Ellipsoid zone and outer retinal integrity also improved on optical 
coherence tomography. The patient tolerated the medication with limited side 
effects.
CONCLUSION: Long-term immunosuppression is the cornerstone of treatment for 
nonparaneoplastic autoimmune retinopathy, although success is highly variable. 
We report a case treated with tocilizumab with dramatic improvement in 
refractory macular edema and reconstitution of the ellipsoid zone on optical 
coherence tomography in a patient with nonparaneoplastic autoimmune retinopathy. 
This case highlights the potential role of treatment with an IL-6 inhibitor in 
autoimmune retinopathy though further studies are needed.