A description of human T-lymphotropic virus type I-related chronic interstitial keratitis in 20 patients.
OBJECTIVE
This study aimed to describe a syndrome that the authors call human T-lymphotropic virus type I-related chronic interstitial keratitis.


METHODS
A consecutive series of 194 human T-lymphotropic virus type I-infected patients (divided into 119 patients with human T-lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis and 75 asymptomatic human T-lymphotropic virus type I carriers) was systematically examined.


RESULTS
Twenty patients (10.3%) had bilateral anterior stromal lesions made up of approximately 10 elevated, rounded or cloudy whitish opacities that were more or less confluent. The opacities were characteristically situated at the periphery of the anterior stroma, and the visual axis remained unaffected. The interstitial keratitis was chronic and unresponsive to topical administration of corticosteroids. It was mainly observed in patients affected by human T-lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis among whom there were 18 cases (15.1%), as opposed to two cases (2.7%) in asymptomatic carriers.


CONCLUSIONS
A new cause of interstitial keratitis is reported. Human T-lymphotropic virus type I infection may have a much broader spectrum of ocular manifestations than previously described. As with the other manifestations of human T-lymphotropic virus type I infection, corneal lesions could be linked to a lymphoplasmocytic infiltration of the stroma leading to corneal opacities.
Service d'Ophtalmologie, Centre Hospitalier Universitaire de Fort de France, Hôpital Pierre Zobda-Quitman, BP 632, 97261 Fort-de-France Cedex, Martinique, France (French West Indies). harold.merle@wanadoo.fr
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003318:Corneal Opacity / Q000453:epidemiology / Q000473:pathology / Q000821:virology*; D003319:Corneal Stroma / Q000473:pathology / Q000821:virology*; D015828:Eye Infections, Viral / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D005260:Female; D015481:HTLV-I Antibodies / Q000032:analysis; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification*; D006801:Humans; D007634:Keratitis / Q000453:epidemiology / Q000473:pathology / Q000821:virology*; D008297:Male; D008395:Martinique / Q000453:epidemiology; D008875:Middle Aged; D015493:Paraparesis, Tropical Spastic / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D011446:Prospective Studies; D013577:Syndrome; D014792:Visual Acuity
D015481:HTLV-I Antibodies