HTLV-I associated uveitis revisited: characteristic grey-white, granular deposits on retinal vessels

To elucidate whether there exists any clinical sign characteristic of HTLV-I associated uveitis.

Fifty five patients with HTLV-I associated uveitis were reviewed. These cases had serum antibodies to HTLV-I, and any other uveitis entities were carefully excluded by means of clinical and laboratory studies.

Eight cases (14.5%) developed vascular lesions in the retina, characterised by grey-white, granular deposits scattered on the retinal veins and/or arteries in the posterior pole. The vascular changes did not accompany any haemorrhage, sheathing, or leakage of fluorescent dye on angiograms, and the retina was otherwise unremarkable. A single or clustered form of similar materials was also found to deposit on the vitreo-retinal interface of the foveolar area. These deposits resolved in a few weeks spontaneously or in response to corticosteroids together with anterior uveal inflammation.

The vascular lesions described here suggest a characteristic sign for HTLV-I associated uveitis, and it may provide, if recognised, an additional clinical marker to establish diagnosis.