Human T-cell lymphotropic virus type 1 (HTLV-1) associated intermediate uveitis mainly presents in patients older than 50, and visual prognosis in these patients is favorable, according to a study published in Archivos de la Sociedad Española de Oftalmología. 

Researchers included 18 patients (28 eyes, mean age 57.3 years, 66.6% women) with HTLV-1 associated intermediate uveitis in a retrospective, longitudinal study conducted  at a single center between 2012 and 2018. The primary objective was to identify characteristics associated with presentation, treatment, and follow-up.

Researchers noted that 33.3% of patients presented with bilateral involvement. Common symptoms included blurred/diminished vision and floaters, which affected 78.6% and 57.1% of the cohort, respectively. The average intraocular pressure was 14.95 mmHg, and best corrected visual acuity (BCVA) was 20/40 or better in 53.6% of patients. Half of the eyes exhibited keratic precipitates, with 17.9% of these stellate. 


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In total, 53.6% of patients received periocular corticosteroid injections as treatment. Frequent complications included epimacular membrane (50%), cataract (21.4%), and glaucoma (7.1%). Visual prognosis was good, according to the report, with only 2 eyes losing a line of vision and 85.7% of patients experiencing better than 20/40 vision at the conclusion of the study. The disease manifested binocularly in 55.5% of patients over the study duration compared with 33.3% at baseline. In total, 60.7% of patients experienced chronic disease. 

Investigators highlight the favorable prognosis in patients with HTLV-1 associated intermediate uveitis: “Complications were mild, the most frequent being epimacular membrane; however, this was clinically significant in only one eye. No other complications were found, such as cystoid macular edema or vitreous hemorrhage, which are common in other intermediate uveitis such as pars planitis.”

Study limitations include its retrospective nature, single center design, and the use of serological tests instead of molecular tests for virus detection.

Reference

Siverio-Llosa C, Silva-Ocas I, Gálvez-Olórtegui T, Arana-Kaik G. Clinical course of HTLV-1 infection associated intermediate uveitis. Arch Soc Esp Oftalmol (Engl Ed). Published online May 24, 2022. doi:10.1016/j.oftale.2021.05.004.