Ocular manifestations in patients with HTLV-I associated infection--a clinical study of 93 cases

Jpn J Ophthalmol. 1996;40(2):260-70.

Abstract

The purpose of this study was to confirm that ophthalmological features seen in patients in Martinique, French West Indies, could be linked to infection by HTLV-I. The authors studied 93 HTLV-I infected patients divided into 70 patients with HTLV-I associated myelopathy/tropical spastic paraparesis (HAM/TSP) and 23 asymptomatic HTLV-I carriers. They did a complete ophthalmological examination with an assessment of lacrymal secretion by means of three tests: Shirmer 1, break-up time and rose Bengal. Some patients had a biopsy of secondary salivary glands. When possible, detection of HTLV-I antibodies was carried out in the aqueous humor. In 45 of the 93 patients (48.4%) the presence of dry keratoconjunctivitis was recorded. In 22 of these 45 cases, a biopsy of the secondary salivary glands showed the presence of lymphoplasmocytoid infiltrations comparable to the glandular changes that occur with Gougerot-Sjögren syndrome. Among the 93 patients, 15 cases of uveitis were noted (16.1%) with 13 cases of anterior uveitis and 11 cases of vitritis. The inflammation was bilateral in 9 cases (9/15 = 60%). Two cases of cotton wool spots, 3 cases of abnormalities in the distribution of the retinal pigment and 7 cases of corneal lesions were also noted. Higher levels of anti-HTLV-I antibodies were detected in the aqueous humor of 3 patients with uveitis. The coexistence of dry eye (keratoconjunctivitis), uveitis and retinal microangiopathy in patients who are suffering from HAM/TSP could suggest the involvement of an autoimmune or immunological mechanism in the physiopathology of the illness.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Eye Diseases / epidemiology
  • Eye Diseases / etiology*
  • Eye Diseases / pathology
  • Female
  • HTLV-I Antibodies / analysis
  • HTLV-I Infections / complications*
  • HTLV-I Infections / epidemiology
  • Humans
  • Male
  • Martinique / epidemiology
  • Middle Aged
  • Paraparesis, Tropical Spastic / complications*
  • Paraparesis, Tropical Spastic / epidemiology

Substances

  • HTLV-I Antibodies