Purpose: To define the long-term clinical course and visual outcome of huma
n T-cell lymphotrophic virus type I (HTLV-I)-associated uveitis (HAU).
Methods: We reviewed the clinical data on 96 eves of 70 patients, 26 men an
d 44 women, with HAU, with specific reference to recurrence of the disease
and long-term visual outcome. The mean follow-up period was 83 months (rang
e, 12-276 months).
Results: The mean age of onset was 42.5 years (range, 7-78 years of age), w
ith men presenting at a significantly younger age. Forty-seven patients had
isolated HAU; in 10 patients, HTLV-I-associated myelopathy occurred before
or after the onset of HAU; in 14 patients, hyperthyroidism had preceded HA
U. A single episode of mild to moderate acute uveal inflammation with resol
ution in a few weeks or more occurred in 44 (67.9%) patients, and multiple
episodes in 26 (37.1%), with a mean interval of 16 months (range, 1-250 mon
ths), which affected the same eye, fellow eye, or both. The majority of pat
ients had favorable visual outcome at the last examination, whereas only a
few patients suffered poor vision resulting from steroid cataract and retin
ochoroidal degeneration.
Conclusions: The clinical course of HAU is virtually benign and its visual
outcome is favorable, although its recurrence is common. The uveitis is usu
ally isolated and affects a portion of otherwise unremarkable HTLV-I carrie
rs, but it may sometimes be manifest as a symptom of syndromic diseases suc
h as HTLV-I-associated myelopathy or hyperthyroidism. This study describes
for the first time cases of HAU that occurred many years before manifestati
on of HTLV-I-associated myelopathy. (C) 1999 Japanese Ophthalmological Soci
ety.