Clinical features of human T lymphotropic virus type 1-associated uveitis in Hokkaido, Japan

Jpn J Ophthalmol. 2013 Jul;57(4):379-84. doi: 10.1007/s10384-013-0244-x. Epub 2013 Apr 23.

Abstract

Purpose: To clarify the clinical features of human lymphotropic virus type 1 (HTLV-1)-associated uveitis (HAU) in patients of Hokkaido University Hospital, Hokkaido, northern Japan.

Methods: We reviewed the records of a consecutive series of 21 patients with HAU who were followed up for more than 12 months at Hokkaido University Hospital.

Results: Of the 21 patients enrolled in this study, 19 as well as their parents (90.5 %) were born in Hokkaido. One patient was a member of the Ainu ethnic group. Unilateral involvement was found in 16 cases (76 %). In the ophthalmological examinations, vitreous opacity was most frequently followed by keratic precipitate, iris/gonio nodules, and posterior synechiae, while hypopyon, retinal vasculitis, and neovascularization were rarely observed. Intraocular inflammation was controlled by topical treatment, while systemic corticosteroids were required in less than one-fourth of patients. Visual acuity improved in 15 patients, remained unchanged in four patients, and deteriorated in two patients. HAU was observed in two patients with adult T-cell leukemia/lymphoma (ATLL). Three out of the four patients (75 %) for whom HLA typing was available had HLA-A26.

Conclusions: A number of clinical features were unique to Hokkaido, namely, predominant unilateral involvement, as well as two HAU patients with ATLL. The phylogenetic difference of HTLV-1 and HLA typing may correlate with different clinical manifestations in HAU.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alleles
  • Antibodies, Viral / immunology*
  • DNA, Viral / analysis
  • Diagnosis, Differential
  • Electroretinography
  • Eye Infections, Viral / diagnosis
  • Eye Infections, Viral / drug therapy
  • Eye Infections, Viral / virology*
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Fundus Oculi
  • Glucocorticoids / therapeutic use
  • HLA-A Antigens / genetics
  • HTLV-I Infections / diagnosis
  • HTLV-I Infections / drug therapy
  • HTLV-I Infections / virology*
  • Human T-lymphotropic virus 1 / genetics
  • Human T-lymphotropic virus 1 / immunology*
  • Humans
  • Japan
  • Middle Aged
  • Ophthalmoscopy
  • Polymerase Chain Reaction
  • Uveitis / diagnosis
  • Uveitis / drug therapy
  • Uveitis / virology*
  • Visual Acuity

Substances

  • Antibodies, Viral
  • DNA, Viral
  • Glucocorticoids
  • HLA-A Antigens