{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T05:13:02Z","timestamp":1778562782293,"version":"3.51.4"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Cytokine storm syndrome (CSS) represents a severe systemic inflammatory condition precipitated by the hyperactivation of immune cells and the consequent excessive release of cytokines, triggered by various factors. This report details the case of a 23-year-old woman admitted with acute high fever and subsequently referred to the ophthalmology department due to blurred vision. Multimodal imaging documented the progression of inflammatory cytokine storm in her fundus, and intraocular fluid analysis revealed abnormal cytokine levels. Following the resolution of inflammation, ocular symptoms and signs showed marked improvement. This report describes ocular manifestations of cytokine storm syndrome, underscoring the susceptibility of the fundus to systemic immune dysregulation despite the presence of the blood-retinal barrier.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1835853","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T04:30:10Z","timestamp":1778560210000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Cytokine storm syndrome causing retinal inflammatory factor storm"],"prefix":"10.3389","volume":"17","author":[{"given":"Na","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Zibo Central Hospital","place":["Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingyi","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Zibo Central Hospital","place":["Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaixia","family":"Zhai","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Zibo Central Hospital","place":["Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaopeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Zibo Central Hospital","place":["Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"11740","DOI":"10.3390\/ijms231911740","article-title":"Cytokine storm\u2014definition, causes, and implications","volume":"23","author":"Jarczak","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-med-042921-112837","article-title":"Cytokine storm syndrome","volume":"74","author":"Cron","year":"2023","journal-title":"Annu Rev Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1056\/nejmra2026131","article-title":"Cytokine storm","volume":"383","author":"Fajgenbaum","year":"2020","journal-title":"N Engl J Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1362","DOI":"10.3390\/v13071362","article-title":"The mechanism behind influenza virus cytokine storm","volume":"13","author":"Gu","year":"2021","journal-title":"Viruses"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.trsl.2021.03.002","article-title":"COVID-19 and cytokine storm syndrome: are there lessons from macrophage activation syndrome","volume":"232","author":"Ombrello","year":"2021","journal-title":"Trans Res"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.7150\/ijbs.59272","article-title":"Cytokine storm in COVID-19: from viral infection to immune responses, diagnosis and therapy","volume":"18","author":"Jiang","year":"2022","journal-title":"Int J Biol Sci"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.570993","article-title":"Controlling cytokine storm is vital in COVID-19","volume":"11","author":"Tang","year":"2020","journal-title":"Front Immunol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1097\/icu.0000000000000801","article-title":"Retinal and choroidal manifestations of COVID-19","volume":"32","author":"Zhang","year":"2021","journal-title":"Curr Opin Ophthalmol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.2147\/ijgm.s399806","article-title":"Ophthalmic manifestations among patients surviving COVID-19","volume":"16","author":"Loduca Lima","year":"2023","journal-title":"Int J Gen Med"},{"key":"B10","article-title":"COVID\u201019 retinal microangiopathy as an in vivo biomarker of systemic vascular disease","volume":"289","author":"Landecho","year":"2020","journal-title":"J Internal Med"},{"key":"B11","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1080\/09273948.2016.1277247","article-title":"Roles of IL-6 in ocular inflammation: a review","volume":"26","author":"Ghasemi","year":"2017","journal-title":"Ocular Immunol Inflammation"},{"key":"B12","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.exer.2018.09.009","article-title":"Inhibition of interleukin-6 trans-signaling prevents inflammation and endothelial barrier disruption in retinal endothelial cells","volume":"178","author":"Valle","year":"2019","journal-title":"Exp Eye Res"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1097\/iae.0b013e31816576d5","article-title":"Proinflammatory cytokines and angiogenic and anti-angiogenic factors in vitreous of patients with proliferative diabetic retinopathy and eales' disease","volume":"28","author":"Ponnalagu","year":"2008","journal-title":"Retina"},{"key":"B14","article-title":"Impact of interleukin-6 promoter polymorphism and serum interleukin-6 level on the acute inflammation and neovascularization stages of patients with Eales' disease","volume":"17","author":"Aditi","year":"2011","journal-title":"Mol Vision"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1097\/iae.0b013e31823496a3","article-title":"Effect of intravitreal methotrexate and aqueous humor cytokine levels in refractory retinal vasculitis in Behcet disease","volume":"32","author":"Hun","year":"2012","journal-title":"Retina"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.09-3375","article-title":"Role of IL-6 in angiotensin II\u2013induced retinal vascular inflammation","volume":"51","author":"Rojas","year":"2010","journal-title":"Invest Opthalmology Visual Sci"},{"key":"B17","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1038\/s42003-023-04905-z","article-title":"Vascular cell-adhesion molecule 1 (VCAM-1) regulates JunB-mediated IL-8\/CXCL1 expression and pathological neovascularization","volume":"6","author":"Kaur","year":"2023","journal-title":"Commun Biol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.exer.2012.05.012","article-title":"Characterization of retinal expression of vascular cell adhesion molecule (VCAM-1) during experimental autoimmune uveitis","volume":"101","author":"Makhoul","year":"2012","journal-title":"Exp Eye Res"},{"key":"B19","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.exer.2015.06.017","article-title":"ICAM-1 and VCAM-1 are differentially expressed on blood-retinal barrier cells during experimental autoimmune uveitis","volume":"137","author":"Dewispelaere","year":"2015","journal-title":"Exp Eye Res"},{"key":"B20","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1186\/s12974-022-02562-3","article-title":"Macrophages in close proximity to the vitreoretinal interface are potential biomarkers of inflammation during retinal vascular disease","volume":"19","author":"Rajesh","year":"2022","journal-title":"J Neuroinflamm"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1097\/iae.0000000000004100","article-title":"Epiretinal macrophage-like cells on optical coherence tomography","volume":"44","author":"Zeng","year":"2024","journal-title":"Retina"},{"key":"B22","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1167\/tvst.13.5.15","article-title":"Vitreoretinal interface cells correlate in vivo with uveitis activity and decrease with anti-inflammatory treatment","volume":"13","author":"Pichi","year":"2024","journal-title":"Trans Vision Sci Technol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"5320","DOI":"10.1038\/s41598-023-32455-1","article-title":"Elevated number and density of macrophage-like cell as a novel inflammation biomarker in diabetic macular edema","volume":"13","author":"Wang","year":"2023","journal-title":"Sci Rep"},{"key":"B24","doi-asserted-by":"publisher","first-page":"7470","DOI":"10.3390\/jcm11247470","article-title":"Retinal macrophage-like cells as a biomarker of inflammation in retinal vein occlusions","volume":"11","author":"Maltsev","year":"2022","journal-title":"J Clin Med"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.855466","article-title":"Characterization of macrophage-like cells in retinal vein occlusion using en face optical coherence tomography","volume":"13","author":"Zeng","year":"2022","journal-title":"Front Immunol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.1095296","article-title":"Characteristics of macrophage-like cells in acute nonarteritic anterior ischemic optic neuropathy and the normal fellow eyes on en face optical coherence tomography","volume":"13","author":"Wang","year":"2022","journal-title":"Front Immunol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1080\/09273948.2022.2080719","article-title":"Macrophage-like cells characterized by en face optical coherence tomography was associated with fluorescein vascular leakage in Beh\u00e7et\u2019s uveitis","volume":"31","author":"Zeng","year":"2022","journal-title":"Ocular Immunol Inflammation"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1835853\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T04:30:34Z","timestamp":1778560234000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1835853\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,12]]},"references-count":27,"alternative-id":["10.3389\/fimmu.2026.1835853"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1835853","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,12]]},"article-number":"1835853"}}