Sekine N, Suzuki J, Takeda M, Igarashi Y, Nakagawa T, Watanabe T, Sato T, Wakai S, Tachi N
Department of Ophthamology, Sapporo Medical College, Japan.
Nippon Ganka Gakkai Zasshi. 1993 Jan;97(1):135-40.
The authors report a case of macular involvement in a patient with HTLV-I associated myelopathy (HAM). The patient was a 10-year-old girl who noticed sudden decreased vision in her right eye in November 1987. The corrected visual acuity was 0.01 in the right eye and 1.0 in the left eye. Fundus examination of the right eye disclosed mild optic disc pallor. The macula appeared to have pigmentary mottling with superficial irregular retinal reflex that was three disc diameters in size. Fluorescein angiography revealed a discoid hypofluorescent area in the macula, surrounded by mottled hyperfluorescent areas. She had no contributory family history of ocular disease, but had a history of blood transfusion during an operation for patent ductus arteriosus and ventricular septal defect at the age of 8 months. In November 1990, she developed gait disturbance due to spastic paraparesis and was admitted to our hospital. Antibodies to HTLV-I were markedly elevated in serum (titer, 1:8192) and in cerebrospinal fluid (titer, 1: 1024). She was diagnosed as HAM. Two months later, she developed encephalopathy and bilateral optic disc atrophy.
作者报告了1例成人T细胞白血病病毒I型（HTLV-I）相关脊髓病（HAM）患者出现黄斑受累的病例。该患者为一名10岁女孩，于1987年11月突然发现右眼视力下降。右眼矫正视力为0.01，左眼为1.0。右眼眼底检查发现轻度视盘苍白。黄斑区可见色素沉着斑，伴有视网膜表面不规则反射，大小为3个视盘直径。荧光素血管造影显示黄斑区有盘状低荧光区，周围为斑驳状高荧光区。她没有眼部疾病的家族史，但在8个月大时因动脉导管未闭和室间隔缺损手术有输血史。1990年11月，她因痉挛性截瘫出现步态障碍，并入住我院。血清中HTLV-I抗体显著升高（滴度为1:8192），脑脊液中HTLV-I抗体也升高（滴度为1:1024）。她被诊断为HAM。两个月后，她出现脑病和双侧视盘萎缩。
