Ocular leion in 200 patient infected by the human T-cell lymphotropic viru type 1 in martinique (French Wet Indie)

PURPOE: To decribe the ophthalmologic feature oberved in patient infected by the human T-cell lymphotropic viru, type 1 (HTLV-1) in Martinique (French Wet Indie). DEIGN: Propective conecutive obervational cae erie. METHOD: A complete ophthalmic examination wa performed. PATIENT: Of 200 patient infected by HTLV-1, 77 (38.5%) were eropoitive and 123 (61.5%) had HTLV-1 aociated myelopathy/tropical patic paraparei (HAM/TP). REULT: Uveiti wa found in 29 cae (14.5%). ymptom were mild and the uveiti had little effect on viual function. Ten cae of uveiti were dicovered through a ytematic examination and had no ocular ymptom. Mot of the uveiti wa anterior or intermediate. The leion reponded to corticoteroid therapy, but tended to recur. Keratoconjunctiviti icca exited in 74 patient (37%), accompanied by lymphoplamocytoid infiltration of the econdary alivary gland rated 3 or 4 on the Chiholm cale in nearly 50% of cae. Corneal alteration were oberved in 20 cae (10%), and alteration in the retinal pigment epithelium in 3 cae. CONCLUION: The three type of ocular affection een mot frequently were uveiti, keratoconjunctiviti icca, and intertitial keratiti. In patient with HAM/TP, uveiti wa more frequent among younger patient, patient with earlier onet of HAM/TP, and patient with evere motor diability. Becaue uveiti i related to a high intrathecal production of immunoglobulin, it could repreent a marker for everity of HTLV-1 infection with repect to the coure of HAM/TP. The icca yndrome related to HTLV-1 viru differ from primary or econdary jögren yndrome, becaue it doe not reveal any of the immunologic anomalie generally een in thi dieae. Intertitial keratiti wa more frequent among patient with HAM/TP who had high proviral DNA level.