Although the AU caused by each of the three types of herpes viruses has a number of common features, each disease also has distinct features that should facilitate an accurate diagnosis.

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Human T cell leukemia virus type 1, also known as human T lymphotropic virus type 1 (HTLV-1), is a retrovirus that encodes a reverse transcriptase, which translates viral RNA into a DNA provirus that is integrated into the host genome. The virus was found to be a causative agent of adult T cell leukemia/lymphoma (ATL) in the early 1980s, and was also found to cause the neurological disorder tropical spastic paraparesis (TSP)/HTLV-1-associated myelopathy (HAM) and the inflammatory disorder HTLV-1 uveitis in the mid 1980s and early 1990s, respectively. This article reviews eye diseases caused by or related to HTLV-1: HTLV-1 uveitis, ocular and systemic complications of HTLV-1, keratoconjunctivitis sicca, interstitial keratitis, and ATL.

Rationale:There are roughly 5 to 10 million persons infected with human T-lymphotropic virus type 1 (HTLV-1) worldwide, and the safety of treating this population with biologics remains poorly understood.Patient concerns and diagnosis:An HTLV-1-infected 66-year-old female with HTLV-1 uveitis (HU) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Her HU had been in remission and her HAM/TSP symptoms had been managed effectively with oral steroids for years. However, she developed severe rheumatoid arthritis (RA) after failing to respond well to conventional anti-rheumatic agents.Interventions:She was administered two intravenous 8mg/kg doses of the biologic tocilizumab.Outcomes:Subsequently, her RA symptoms resolved, but she suffered a recurrence of HU and exacerbation of HAM/TSP symptoms. When she was switched back to steroid-based treatment, HU and HAM symptoms both improved, but RA symptoms again worsened. Finally, an attempt to substitute the biologic abatacept and reduce the steroids failed when HAM/TSP symptoms again became aggravated.Lessons:To the best of our knowledge, this represents the first report worldwide of a biologic aggravating HTLV-1-associated conditions. This report suggests that caution is advised when using biologics to treat HTLV-1-infected patients, though further research is required to clarify the situation.

The FSL-AK effectively reduced corneal astigmatism and improved the UDVA, although it was demonstrated that the deeper incisions led to overcorrection.

Myopia progression as well as increase in axial length occurs in VKH disease. The link between choroidal thinning and axial length elongation in VKH patients gives some insights into axial length increase of pathologic myopia.

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There was a statistically significant difference between younger and older sarcoidosis patients for the disease lesions. Lesions were located around the peripheral area at the posterior segment in older patients.