Aim: To report an alternative cytokine-based customized therapeutic approach of macular edema secondary to retinal vein occlusion. Methods: A 64-year-old male patient presented with left eye macular edema secondary to central retinal vein occlusion, status after three consecutive anti–vascular endothelial growth factor injections. He was subsequently subjected to aqueous humor cytokine analysis. Vascular endothelial growth factor, interleukin-6 (IL-6), and interleukin-8 (IL-8) concentrations were determined using multiplex bead assay (BD Cytometric Bead Array). Based on the results, intravitreal steroid was administered. Follow-up examination included monitoring corrected distance visual acuity using Snellen’s chart, central subfoveal thickness measurement on spectral domain optical coherence tomography (Spectralis, HRA2; Heidelberg engineering, Heidelberg, Germany) and cytokine quantification at the end of one and three months. Results: Baseline corrected distance visual acuity was counting fingers at 1 m, which subsequently improved to 6/12 Snellen equivalent 1 month after customized intravitreal therapy. Central subfoveal thickness demonstrated significant reduction from 529 to 253 μm; baseline vascular endothelial growth factor, IL-6, and IL-8 concentration were ascertained to be 29.94, 1.31, and 82.12 pg/mL (picograms/millilitre). One month after intravitreal steroid injection, the IL-8 levels normalized to 13.28 pg/mL. Functional and anatomical improvements were sustained till the last follow-up at 3 months. Conclusion: Customized intravitreal treatment provides an objective, alternative, and effective therapeutic approach for macular edema secondary to retinal vein occlusion. [ABSTRACT FROM AUTHOR]