Pigmentary retinal degeneration in patients with HTLV-I-associated myelopathy

Ophthalmological evaluations were made of the records of a series of 38 patients with HTLV-I-associated myelopathy, a chronic progressive myelopathy caused by human T-lymphotropic virus type I (HTLV-I). Four patients with no contributory family history showed pigmentary degenerative changes of the retina and choroid. Two of the patients (73-year-old woman, 68-year-old woman) had a progressive visual loss and night blindness with morphologic and functional features of diffuse pigmentary retinal degeneration. The other two patients (59-year-old man, 72-year-old man) complained of recently developed visual loss with sectorial or regional retinochoroidal atrophy. These elderly patients claimed that they had been healthy until a few years before presentation, not only visually but also neurologically. It was concluded, together with an epidemiologic consideration, that the coexistence of pigmentary retinal degeneration and HTLV-I-associated myelopathy is not simply chance but indicates a close association between the two conditions. It is proposed that HTLV-I infection might be a primary causative factor of degenerative changes of the retina and choroid, although the pathogenesis remains to be defined.