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 patie...

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 ...