A case of human T lymphotropic virus type I-associated uveitis with cystoid macular edema

A 41-year-old female complained of acute onset of blurred vision in her right eye in June 1993. Her corrected visual acuity was 0.5 in the right eye and 1.0 in the left eye, and slit-lamp biomicroscopic examination showed keratic precipitates and inflammatory cells in the anterior chamber and vitreous body of her right eye. Ophthalmoscopic examination showed a focal hemorrhage and diffuse opacity of the vitreous in the right eye, and fluorescein angiography revealed moderate leakage of dye from retinal vessels, but the posterior vitreous was not detached. No hemorrhages or exudates were seen in the left eye. Laboratory studies showed that this patient had hyperthyroidism and elevated serum levels of human T lymphotropic virus (HTLV) type I antibodies, leading to a diagnosis of HTLV-I-associated uveitis. The patient was treated with topical corticosteroid agents and the uveal inflammation subsided within 5 weeks. However, cystoid macular edema appeared in this patient's right eye 10 weeks after the start of therapy, causing her visual acuity to drop to 0.3 in this eye. Oral prednisolone treated the cystoid macular edema effectively and the patient's visual acuity improved to 1.0 in the right eye after 16 weeks of therapy, although a posterior vitreous detachment was noted at this time.