Human T-lymphotropic virus type I uveitis after Graves' disease

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Our seroepidemiological, clinical, and virological data have led us to conclude that HTLV-I is closely associated with a certain type of uveitis, and that this disorder is a distinct clinical entity. Although the role of HTLV-I-infected cells and the mechanism by which the intraocular tissues are affected are unknown, it is highly likely that an autoimmune mechanism mediated by HTLV-I-infected cells has an important role.HTLV-I uveitis has several characteristic clinical features. The chief complaints are blurring of vision or floaters with acute or subacute onset. the most characteristic ocular findings are vitreous opacities associated with mild iritis and mild retinal vasculitis. Inflammation was reduced by treatment with topical or systemic corticosteroids, but recurred in about 60% of patients when therapy was discontinued.During the period between January 1989 and April 1992,93 patients were observed with HTLV-I uveitis and a significant correlation was found between Graves'disease and HTLV-I uveitis. Sixteen of the 93 patients with HTLV-I uveitis (17.2%) had a previous history of Graves' disease. Fifteen patients were female (15/60,25.%) and one was male(1/33,3.0%). Interestingly, uveitis occurred after the onset of Graves'disease in all cases. On the other hand, none of 222 patients with idiopathic uveitis who were seronegative to HTLV-I had a history of Graves'disease. Although the mechanisms by which HTLV-I causes the correlation between uveitis and Graves'disease are unknown, the present data suggest that immune mediated or autoimmune mechanisms are involved in HTLV-I uveitis.