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M. Miyanaga, K. Shimizu, T. Kawaguchi, T. Miyai, Y. Osakabe, K. Miyata, M. Mochizuki; A Clinical Survey of Uveitis in HTLV-1 Endemic Area of Japan. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5132.
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To investigate a clinical survey of uveitis in southern Kyushu island of Japan, where human T-lymphotropic virus type 1 (HTLV-1) and toxoplasma is highly endemic.
Clinical charts of patients with uveitis between June 1975 and September 2007 at Miyata Eye Hospital, a referral eye center of the region, were retrospectively reviewed.
A total number of 1338 patients (2012 eyes), consisting of 526 men and 812 women with mean age of 50.5 years old, were analysed in the study. Bilateral uveitis was seen in 674 patients (50.4%). The most frequent clinical entity of uveitis was HTLV-1 uveitis (HU) (17.1%), followed by Vogt-Koyanagi-Harada disease (VKH) (9.9%), sarcoidosis (7.2%), ocular toxoplasmosis (7.1%), Behçet disease (4.3%), HLA-B27 related acute anterior uveitis (AAU) (1.9%), ocular toxocariasis (1.8%), Posner-Schlossman syndrome (1.3%) and many others. Unclassifiable uveitis comprised 38.5% in the series. As for the anatomical diagnosis, anterior uveitis was seen in 30.8%, intermediate uveitis in 17.3%, posterior uveitis in 9.3%, and pan-uveitis in 42.5%. As for the seroprevalence of HTLV-1 and toxoplasma was 24.5% and 68.5% of uveitis patients, respectively. In HU patients 23.6% had a history of Graves’ disease. HLA-DR4 was positive in 88.5% of VKH patients. Among these eyes with uveitis, cataract was seen in 44.7% and glaucoma in 31.9% as ocular complications. As for final visual acuity, 68.2% of eyes kept 20/25 or better and 11.4% of eyes were worse than 20/200. Visual outcome was generally good in AAU, VKH, HU and Posner-Schlossman syndrome, whereas acute retinal necrosis and Behçet disease had much worse visual prognosis.
HU and ocular toxoplasmosis were the major clinical entities in southern Kyushu of Japan. This relates to the high seroprevalence of the infectious agents in this region of Japan.
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