How do you manage a patient with giant cell arteritis treated with weekly tocilizumab and low dose glucocorticoid who develops sudden vision loss?

Fortunately, this scenario is a rare event, as most patients treated with ongoing tocilizumab (TCZ) and prednisone are at a far lower risk for developing new visual loss due to giant cell arteritis (GCA). A recent paper by Amsler et al., PMID 33752737 reviewing the risk for visual loss in patients b...

As mentioned, it would be unexpected and rare to see vision loss, happening to a patient on the steroids and Actemra. The referral to a neuro-ophthalmologist, or probably their usual ophthalmologist in the interest of time if necessary, would be the first step, because I would want to rely on other ...