A CASE OF HUMAN T-LYMPHOTROPIC VIRUS TYPE-I-ASSOCIATED UVEITIS

Title A CASE OF HUMAN T-LYMPHOTROPIC VIRUS TYPE-I-ASSOCIATED UVEITIS
Author, Co-Author Yu Su, Andrew Gurwood
Topic
Year
2009
Day
Friday
Program Number
95533
Room
Crystal H
Affiliation
Pennsylvania College of Optometry at Salus University
Abstract BACKGROUND: Human T-cell lymphotrophic virus type 1 (HTLV-1)is an RNA retrovirus of the Oncovirinae subfamily. It is the causative vector of adult T-cell leukemia/lymphoma (ATLL) and is associated with myelopathy (HAM) and tropical spastic paraparesis (TSP). It may induce a uveitis as part of the syndrome. Such cases have been acknowledged in the literature as Human T-cell lymphotrophic virus type 1 associated uveitis (HAU). HTLV-1 infection is endemic to Japan, the Caribbean islands, parts of Central Africa and South America. T

CASE REPORT(S): A 65-year-old African female presented with hazy vision of 3 weeks duration, OD. Corrected acuity was 20/40 OD. The OD demonstrated old keratic precipitates without evidence of active iritis and grade II vitreous opacities. Observation found mild edema of the retina and diffuse grey-white granular deposits overlying some of the retinal vessels. The patient had already had a neurological consultation with blood studies secondary to a progressive gait decompensation diagnosed by her general physician. Analysis of the ocular signs in the setting of positive serologic testing, positive electrodianostic studies and systemic symptoms yielded the diagnosis of HTLV-1 associated panuveitis (HAU). Treatment with traditional topical antiuveitic therapy in combination with systemic modalities was considered by the team as dictated by the constellation of signs and symptoms. The uveitis regressed over 11 weeks with full visual recovery.

CONCLUSIONS: HTLV-1 positive uveitis is characterized by acute granulomatous or non-granulomatous uveitis accompanied by vitreous opacities and retinal vasculitis. The condition is uncovered with standard laboratory studies and responds well to topical and systemic corticosteroids. Resolution is frequently uncomplicated taking place over the course of a few weeks from the onset of symptoms. The visual outcome is generally positive
Affiliation of Co-Authors Pennsylvania College of Optometry at Salus University
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