A description of human T-lymphotropic virus type I-related chronic interstitial keratitis in 20 patients

OBJECTIVE: This study aimed to describe a syndrome that the authors call hu man T-lymphotropic virus type I-related chronic interstitial keratitis. METHODS: A consecutive series of 194 human T-lymphotropic virus type I-infe cted patients (divided into 119 patients with human T-lymphotropic virus ty pe I-associated myelopathy/tropical spastic paraparesis and 75 asymptomatic human T-lymphotropic virus type I carriers) was systematically examined. RESULTS: Twenty patients (10.3%) had bilateral anterior stromal lesions mad e up of approximately 10 elevated, rounded or cloudy whitish opacities that were more or less confluent. The opacities were characteristically situate d at the periphery of the anterior stroma, and the visual axis remained una ffected, The interstitial keratitis was chronic and unresponsive to topical administration of corticosteroids. It was mainly observed in patients affe cted by human T-lymphotropic virus type I-associated myelopathy/tropical sp astic paraparesis among whom there were 18 cases (15.1%), as opposed to two cases (2.7%) in asymptomatic carriers. CONCLUSION: A new cause of interstitial keratitis is reported. Human T-lymp hotropic virus type I infection may have a much broader spectrum of ocular manifestations than previously described. As with the other manifestations of human T-lymphotropic virus type I infection, corneal lesions could be li nked to a lymphoplasmocytic infiltration of the stroma leading to corneal o pacities. (Am J Ophthalmol 2001;131:305-308. (C) 2001 by Elsevier Science I nc, All rights reserved.).