New corneal findings in human T-cell lymphotrophic virus type 1 infection.
OBJECTIVE
Human T-cell lymphotrophic virus type 1 is a RNA retrovirus that primarily affects CD4+ T-cells. Human T-cell lymphotrophic virus type 1 infection is the established cause of adult T-cell leukemia/lymphoma, an aggressive malignancy of CD4+ T-cells, and two nonneoplastic conditions: human T-cell lymphotrophic virus type 1-associated myelopathy/tropical spastic paraparesis and human T-cell lymphotrophic virus type 1 uveitis. Other reported ophthalmic manifestations of human T-cell lymphotrophic virus type 1 infection include lymphomatous and leukemic infiltrates in the eye and ocular adnexa in patients with adult T-cell leukemia/lymphoma, retinal pigmentary degeneration, and neuro-ophthalmic disorders in patients with human T-cell lymphotrophic virus type 1-associated myelopathy/tropical spastic paraparesis and keratoconjunctivitis sicca, episcleritis, and sclerouveitis in asymptomatic human T-cell lymphotrophic virus type 1 carriers. This report describes the ocular findings in three Jamaican patients with human T-cell lymphotrophic virus type 1 infection and adult T-cell leukemia/lymphoma.


METHODS
The clinical records of three patients with human T-cell lymphotrophic virus type 1 infection and adult T-cell leukemia/lymphoma examined at the National Eye Institute were reviewed. Each patient had one or more complete ophthalmic evaluations.


RESULTS
All three patients had corneal abnormalities, including corneal haze and central opacities with thinning; bilateral immunoprotein keratopathy; and peripheral corneal thinning, scarring, and neovascularization. All three patients had elevated serum immunoglobulin levels.


CONCLUSIONS
We believe that the novel corneal findings in these patients are most likely a consequence of the hypergammaglobulinemia induced by the human T-cell lymphotrophic virus type 1 infection or the T-cell malignancy.
Laboratory of Immunology, National Eye Institute, National Institutes of Health, 10 Center Drive, Bldg. 10, Room 10 N112, Bethesda, MD 20892-1857, USA. BuggageR@intra.nei.nih.gov
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Buggage
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Levy-Clarke
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Smith
D000328:Adult; D003316:Corneal Diseases / Q000175:diagnosis / Q000208:ethnology / Q000821:virology*; D015828:Eye Infections, Viral / Q000175:diagnosis / Q000208:ethnology / Q000821:virology; D005260:Female; D015481:HTLV-I Antibodies / Q000032:analysis; D015368:Human T-lymphotropic virus 1 / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D006942:Hypergammaglobulinemia / Q000276:immunology / Q000821:virology; D007074:Immunoglobulin G / Q000276:immunology; D007563:Jamaica / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015493:Paraparesis, Tropical Spastic / Q000175:diagnosis / Q000208:ethnology / Q000821:virology; D014792:Visual Acuity
D015481:HTLV-I Antibodies; D007074:Immunoglobulin G