title: Ocular manifestations in patients with HTLV-I associated infection--a clinical study of 93 cases.
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.
authors.affiliation: Service d'Ophtalmologie, Centre Hospitalier Universitaire de Fort-de-France, Martinique, French West Indies.
authors.forename: H
authors.initials: H
authors.lastname: Merle
authors.forename: D
authors.initials: D
authors.lastname: Smadja
authors.forename: P
authors.initials: P
authors.lastname: Le Hoang
authors.forename: O
authors.initials: O
authors.lastname: Bera
authors.forename: P
authors.initials: P
authors.lastname: Cabre
authors.forename: M
authors.initials: M
authors.lastname: Landau
authors.forename: J C
authors.initials: JC
authors.lastname: Vernant
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005128:Eye Diseases / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D005260:Female; D015481:HTLV-I Antibodies / Q000032:analysis; D015490:HTLV-I Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008395:Martinique / Q000453:epidemiology; D008875:Middle Aged; D015493:Paraparesis, Tropical Spastic / Q000150:complications* / Q000453:epidemiology
chemical_list: D015481:HTLV-I Antibodies