Clinical features of human T lymphotropic virus type 1-associated uveitis in Hokkaido, Japan

To clarify the clinical features of human lymphotropic virus type 1 (HTLV-1)-associated uveitis (HAU) in patients of Hokkaido University Hospital, Hokkaido, northern Japan.

We reviewed the records of a consecutive series of 21 patients with HAU who were followed up for more than 12 months at Hokkaido University Hospital.

Of the 21 patients enrolled in this study, 19 as well as their parents (90.5 %) were born in Hokkaido. One patient was a member of the Ainu ethnic group. Unilateral involvement was found in 16 cases (76 %). In the ophthalmological examinations, vitreous opacity was most frequently followed by keratic precipitate, iris/gonio nodules, and posterior synechiae, while hypopyon, retinal vasculitis, and neovascularization were rarely observed. Intraocular inflammation was controlled by topical treatment, while systemic corticosteroids were required in less than one-fourth of patients. Visual acuity improved in 15 patients, remained unchanged in four patients, and deteriorated in two patients. HAU was observed in two patients with adult T-cell leukemia/lymphoma (ATLL). Three out of the four patients (75 %) for whom HLA typing was available had HLA-A26.

A number of clinical features were unique to Hokkaido, namely, predominant unilateral involvement, as well as two HAU patients with ATLL. The phylogenetic difference of HTLV-1 and HLA typing may correlate with different clinical manifestations in HAU.