Japanese Journal of Ophthalmology

, Volume 57, Issue 4, pp 379–384 | Cite as

Clinical features of human T lymphotropic virus type 1-associated uveitis in Hokkaido, Japan

  • Satoru Kase
  • Kenichi NambaEmail author
  • Nobuyoshi Kitaichi
  • Daiju Iwata
  • Shigeaki Ohno
  • Susumu Ishida
Clinical Investigation



To clarify the clinical features of human lymphotropic virus type 1 (HTLV-1)-associated uveitis (HAU) in patients of Hokkaido University Hospital, Hokkaido, northern Japan.


We reviewed the records of a consecutive series of 21 patients with HAU who were followed up for more than 12 months at Hokkaido University Hospital.


Of the 21 patients enrolled in this study, 19 as well as their parents (90.5 %) were born in Hokkaido. One patient was a member of the Ainu ethnic group. Unilateral involvement was found in 16 cases (76 %). In the ophthalmological examinations, vitreous opacity was most frequently followed by keratic precipitate, iris/gonio nodules, and posterior synechiae, while hypopyon, retinal vasculitis, and neovascularization were rarely observed. Intraocular inflammation was controlled by topical treatment, while systemic corticosteroids were required in less than one-fourth of patients. Visual acuity improved in 15 patients, remained unchanged in four patients, and deteriorated in two patients. HAU was observed in two patients with adult T-cell leukemia/lymphoma (ATLL). Three out of the four patients (75 %) for whom HLA typing was available had HLA-A26.


A number of clinical features were unique to Hokkaido, namely, predominant unilateral involvement, as well as two HAU patients with ATLL. The phylogenetic difference of HTLV-1 and HLA typing may correlate with different clinical manifestations in HAU.


HTLV-1 Uveitis Adult T-cell leukemia Hokkaido 



This study was supported by the Research foundation of the Japan Society for the Promotion of Science, by a grant for Research on Sensory and Communicative Disorders from The Ministry of Health, Labour, and Welfare, and by grants-in-aid for Scientific Research from The Ministry of Education, Culture, Sports, Science, and Technology (MEXT).


  1. 1.
    Gallo RC. The discovery of the first human retrovirus: HTLV-1 and HTLV-2. Retrovirology. 2005;2:17.PubMedCrossRefGoogle Scholar
  2. 2.
    de Thè G, Bomford R. An HTLV-I vaccine: why, how, for whom? AIDS Res Hum Retrovir. 1993;9:381–6.PubMedCrossRefGoogle Scholar
  3. 3.
    Journo C, Mahieux R. HTLV-1 and innate immunity. Viruses. 2011;3:1374–94.PubMedCrossRefGoogle Scholar
  4. 4.
    Goto H, Mochizuki M, Yamaki K, Kotake S, Usui M, Ohno S. Epidemiological survey of intraocular inflammation in Japan. Jpn J Ophthalmol. 2007;51:41–4.PubMedCrossRefGoogle Scholar
  5. 5.
    Ohguro N, Sonoda KH, Takeuchi M, Matsumura M, Mochizuki M. The 2009 prospective multi-center epidemiologic survey of uveitis in Japan. Jpn J Ophthalmol. 2012;56:432–5.PubMedCrossRefGoogle Scholar
  6. 6.
    Mochizuki M, Watanabe T, Yamaguchi K, Tajima K, Yoshimura K, Nakashima S, et al. Uveitis associated with human T lymphotropic virus type I: seroepidemiologic, clinical, and virologic studies. J Infect Dis. 1992;166:943–4.PubMedCrossRefGoogle Scholar
  7. 7.
    Yamaguchi K, Watanabe T. Human T lymphotropic virus type-I and adult T-cell leukemia in Japan. Int J Hematol. 2002;76[Suppl 2]:240–5.PubMedCrossRefGoogle Scholar
  8. 8.
    Madeleine MM, Wiktor SZ, Goedert JJ, Manns A, Levine PH, Biggar RJ, et al. HTLV-I and HTLV-II world-wide distribution: reanalysis of 4,832 immunoblot results. Int J Cancer. 1993;54:255–60.PubMedCrossRefGoogle Scholar
  9. 9.
    Goto K, Saeki K, Kurita M, Iijima Y, Miyake A, Ohno S. HTLV-I seroprevalence in patients with undefined uveitis in central Japan. Jpn J Ophthalmol. 1994;38:175–7.PubMedGoogle Scholar
  10. 10.
    Goto K, Saeki K, Kurita M, Ohno S. HTLV-I associated uveitis in central Japan. Br J Ophthalmol. 1995;79:1018–20.PubMedCrossRefGoogle Scholar
  11. 11.
    Kitamei H, Kitaichi N, Namba K, Kotake S, Goda C, Kitamura M, et al. Clinical features of intraocular inflammation in Hokkaido, Japan. Acta Ophthalmol. 2009;87:424–8.PubMedCrossRefGoogle Scholar
  12. 12.
    Ohba N, Nakao K, Isashiki Y, Osame M, Sonoda S, Yashiki S, et al. A multicenter case-control study of HTLV-I associated uveitis. Study group for HTLV-I associated ocular diseases. Jpn J Ophthalmol. 1994;38:162–7.PubMedGoogle Scholar
  13. 13.
    Brace CL, Nelson AR, Seguchi N, Oe H, Sering L, Qifeng P, et al. Old World sources of the first New World human inhabitants: a comparative craniofacial view. Proc Natl Acad Sci USA. 2001;98:10017–22.PubMedCrossRefGoogle Scholar
  14. 14.
    Yoshimura K, Mochizuki M, Araki S, Miyata N, Yamaguchi K, Tajima K, et al. Clinical and immunologic features of human T-cell lymphotropic virus type I uveitis. Am J Ophthalmol. 1993;116:156–63.PubMedGoogle Scholar
  15. 15.
    Merle H, Cabre P, Olindo S, Merle S, Smadja D. Ocular lesions in 200 patients infected by the human T-cell lymphotropic virus type 1 in martinique (French West Indies). Am J Ophthalmol. 2002;134:190–5.PubMedCrossRefGoogle Scholar
  16. 16.
    Nakao K, Ohba N, Nakagawa M, Osame M. Clinical course of HTLV-I-associated uveitis. Jpn J Ophthalmol. 1999;43:404–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Nakao K, Ohba N, Otsuka S, Okubo A, Yanagita T, Hashimoto N, et al. HTLV-I associated uveitis and hyperthyroidism. Jpn J Ophthalmol. 1994;38:56–61.PubMedGoogle Scholar
  18. 18.
    Yamaguchi K, Mochizuki M, Watanabe T, Yoshimura K, Shirao M, Araki S, et al. Human T lymphotropic virus type 1 uveitis after Graves’ disease. Br J Ophthalmol. 1994;78:163–6.PubMedCrossRefGoogle Scholar
  19. 19.
    Nakao K, Ohba N. Clinical features of HTLV-I associated uveitis. Br J Ophthalmol. 1993;77:274–9.PubMedCrossRefGoogle Scholar
  20. 20.
    Goncalves DU, Proietti FA, Ribas JG, Araujo MG, Pinheiro SR, Guedes AC, et al. Epidemiology, treatment, and prevention of human T-cell leukemia virus type 1-associated diseases. Clin Microbiol Rev. 2010;23:577–89.PubMedCrossRefGoogle Scholar
  21. 21.
    Sagawa K, Mochizuki M, Masuoka K, Katagiri K, Katayama T, Maeda T, et al. Immunopathological mechanisms of human T cell lymphotropic virus type 1 (HTLV-I) uveitis. Detection of HTLV-I-infected T cells in the eye and their constitutive cytokine production. J Clin Invest. 1995;95:852–8.PubMedCrossRefGoogle Scholar
  22. 22.
    Hirata A, Miyazaki T, Tanihara H. Intraocular infiltration of adult T-cell leukemia. Am J Ophthalmol. 2002;134:616–8.PubMedCrossRefGoogle Scholar
  23. 23.
    Shibata K, Shimamoto Y, Nishimura T, Okinami S, Yamada H, Miyahara M. Ocular manifestations in adult T-cell leukemia/lymphoma. Ann Hematol. 1997;74:163–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Sugita S, Takase H, Yoshida T, Sugamoto Y, Watanabe T, Mochizuki M. Intraocular soluble IL-2 receptor alpha in a patient with adult T cell leukaemia with intraocular invasion. Br J Ophthalmol. 2006;90:1204–6.PubMedCrossRefGoogle Scholar
  25. 25.
    Merle H, Donnio A, Gonin C, Jean-Charles A, Panelatti G, Plumelle Y. Retinal vasculitis caused by adult T-cell leukemia/lymphoma. Jpn J Ophthalmol. 2005;49:41–5.PubMedCrossRefGoogle Scholar
  26. 26.
    Liu MM, Furusato E, Cao X, Shen D, Chan CC. Ocular manifestations and pathology of adult T-cell leukemia/lymphoma associated with human T-lymphotropic virus type 1. Rare Tumors. 2010;2:e63.PubMedGoogle Scholar
  27. 27.
    Yamashita M, Ishida T, Ohkura S, Miura T, Hayami M. Phylogenetic characterization of a new HTLV type 1 from the Ainu in Japan. AIDS Res Hum Retrovir. 2001;17:783–7.PubMedCrossRefGoogle Scholar
  28. 28.
    Gessain A, Gallo RC, Franchini G. Low degree of human T-cell leukemia/lymphoma virus type I genetic drift in vivo as a means of monitoring viral transmission and movement of ancient human populations. J Virol. 1992;66:2288–95.PubMedGoogle Scholar
  29. 29.
    Verdonck K, Gonzalez E, Van Dooren S, Vandamme AM, Vanham G, Gotuzzo E. Human T-lymphotropic virus 1: recent knowledge about an ancient infection. Lancet Infect Dis. 2007;7:266–81.PubMedCrossRefGoogle Scholar
  30. 30.
    Ono A, Miura T, Araki S, Yamaguchi K, Takatsuki K, Mori S, et al. Subtype analysis of HTLV-1 in patients with HTLV-1 uveitis. Jpn J Cancer Res. 1994;85:767–70.PubMedCrossRefGoogle Scholar
  31. 31.
    Kaminagayoshi T, Nakao K, Yashiki S, Sonoda S, Ohba N, Sakamoto T. Analysis of HLA class I and class II gene polymorphisms in Japanese patients with human T-cell lymphotropic virus type 1-associated uveitis. Ocul Immunol Inflamm. 2005;13:199–204.PubMedCrossRefGoogle Scholar
  32. 32.
    Sonoda S, Li HC, Tajima K. Ethnoepidemiology of HTLV-1 related diseases: ethnic determinants of HTLV-1 susceptibility and its worldwide dispersal. Cancer Sci. 2011;102:295–301.PubMedCrossRefGoogle Scholar

Copyright information

© Japanese Ophthalmological Society 2013

Authors and Affiliations

  • Satoru Kase
    • 1
  • Kenichi Namba
    • 1
    Email author
  • Nobuyoshi Kitaichi
    • 2
    • 3
  • Daiju Iwata
    • 1
  • Shigeaki Ohno
    • 2
  • Susumu Ishida
    • 1
    • 2
  1. 1.Department of OphthalmologyHokkaido University Graduate School of MedicineKita-ku, SapporoJapan
  2. 2.Department of Ocular Inflammation and ImmunologyHokkaido University Graduate School of MedicineSapporoJapan
  3. 3.Department of OphthalmologyHealth Sciences University of HokkaidoSapporoJapan

Personalised recommendations