Ocular lesions in HTLV-1 infected patients from Salvador, State of Bahia: the city with the highest prevalence of this infection in Brazil

In order to determine the prevalence of ocular lesions in HTLV-1 infected patients in Salvador Bahia, a transversal study was conducted on 140 HTLV-1 infected patients (90 asymptomatic and 50 tropical spastic paraparesis/HTLV-1-associated myelopathy) between June 2004 and November 2005. The ophthalmological examination included visual acuity measurement, ocular motility, biomicroscopy of the anterior and posterior chambers, intraocular pressure and evaluation of lachrymal secretion. Observation verified 4 (2.8%) out of 140 patients with uveitis (two patients had intermediate uveitis and two had pan-uveitis) and 39 (36.4%) out of 107 patients with keratoconjunctivitis sicca. The prevalence of Keratoconjunctivitis sicca was significantly higher among the TSP/HAM patients (OR age adjusted=3.64; 95%CI 1.59-8.32). Uveitis and corneal opacities were also important findings, indicating the strong need for periodic ophthalmological follow-up in all HTLV-1 subjects

Lesões oculares em pacientes infectados pelo HTLV-1 em Salvador, Estado da Bahia: a cidade com maior prevalência desta infecção no Brasil

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2016-07-28T13:16:08Z No. of bitstreams: 1 Rathsam-Pinheiro RH Ocular lesions....pdf: 161923 bytes, checksum: d6e1007e0b76d4c40587aee6aca5a18c (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2016-07-28T13:27:05Z (GMT) No. of bitstreams: 1 Rathsam-Pinheiro RH Ocular lesions....pdf: 161923 bytes, checksum: d6e1007e0b76d4c40587aee6aca5a18c (MD5)Made available in DSpace on 2016-07-28T13:27:05Z (GMT). No. of bitstreams: 1 Rathsam-Pinheiro RH Ocular lesions....pdf: 161923 bytes, checksum: d6e1007e0b76d4c40587aee6aca5a18c (MD5) Previous issue date: 2009Instituto Brasileiro de Oftalmologia e Prevenção da Cegueira. IBOPC. Salvador, BA, Brasil / Escola Bahiana de Medicina e Saúde Pública. EBMSP. Salvador, BA, BrasilEscola Bahiana de Medicina e Saúde Pública. EBMSP. Salvador, BA, BrasilInstituto Brasileiro de Oftalmologia e Prevenção da Cegueira. IBOPC. Salvador, BA, BrasilInstituto Brasileiro de Oftalmologia e Prevenção da Cegueira. IBOPC. Salvador, BA, Brasil / Escola Bahiana de Medicina e Saúde Pública. EBMSP. Salvador, BA, BrasilInstituto Brasileiro de Oftalmologia e Prevenção da Cegueira. IBOPC. Salvador, BA, Brasil / Escola Bahiana de Medicina e Saúde Pública. EBMSP. Salvador, BA, BrasilEscola Bahiana de Medicina e Saúde Pública. EBMSP. Salvador, BA, Brasil / Fundação Gonçalo Moniz. Centro de Pesquisas Gonçalo Moniz. Laboratório Avançado de Saúde Publica. Salvador, BA, BrasilCom o objetivo de determinar a prevalência de lesões oculares, em portadores de HTLV-1 em Salvador, Bahia, foi realizado um estudo transversal em 140 pacientes (90 assintomático e 50 com paraparesia espática tropical/mielopatia associada ao vírus linfotrópico de células T humanas) entre junho de 2004 e novembro de 2005. O exame oftalmológico incluiu medida da acuidade visual, exame da motilidade ocular, biomicroscopia anterior e posterior, pressão intraocular e avaliação do filme lacrimal. Observamos 4.0 (2.8%) pacientes com uveites (dois com uveíte intermediária e dois com panuveíte) e 39 (36,4%) pacientes com ceratoconjuntivite seca. A prevalência de Ceratoconjuntivite seca foi significantemente mais elevada entre os pacientes com TSP/HAM (RC ajustada para idade = 3,64; IC 95% 1,59-8,32). As uveítes e opacidades corneanas foram também, patologias importantes, indicando a necessidade de acompanhamento oftalmológico periódico nos portadores de HTLV-1.In order to determine the prevalence of ocular lesions in HTLV-1 infected patients in Salvador Bahia, a transversal study was conducted on 140 HTLV-1 infected patients (90 asymptomatic and 50 tropical spastic paraparesis/HTLV-1-associated myelopathy) between June 2004 and November 2005. The ophthalmological examination included visual acuity measurement, ocular motility, biomicroscopy of the anterior and posterior chambers, intraocular pressure and evaluation of lachrymal secretion. Observation verified 4 (2.8%) out of 140 patients with uveitis (two patients had intermediate uveitis and two had pan-uveitis) and 39 (36.4%) out of 107 patients with keratoconjunctivitis sicca. The prevalence of Keratoconjunctivitis sicca was significantly higher among the TSP/HAM patients (OR age adjusted=3.64; 95%CI 1.59-8.32). Uveitis and corneal opacities were also important findings, indicating the strong need for periodic ophthalmological follow-up in all HTLV-1 subjects

Algorithm for dry eye disease diagnosis in individuals infected with human T-cell lymphotropic virus type 1

<div><p>ABSTRACT Purpose: To evaluate the accuracy of lacrimal film tests and propose an algorithm for the diagnosis of dry eye disease in individuals infected with human T-cell lymphotropic virus type 1. Methods: Ninety-six patients infected with human T-cell lymphotropic virus type 1 were enrolled in the study. To assess clinical complaints, patients completed the Ocular Surface Disease Index questionnaire. To evaluate lacrimal film quality, patients underwent the tear breakup time test, Schirmer I test, and Rose Bengal staining. Dry eye disease was diagnosed when at least two of the three test results were abnormal. The sensitivity, specificity, positive and negative predictive values, and overall accuracy of the questionnaire as well as of each test alone and combined in parallel and in series were determined. Results: The most sensitive test was the tear breakup time test (98%), whereas the most specific was the Schirmer I test (100%). Rose Bengal staining had the highest overall accuracy (88.64%), whereas the Ocular Surface Disease Index had the lowest overall accuracy (62.65%). The tear breakup time test, Schirmer I test, and Ocular Surface Disease Index combined in parallel showed increased sensitivity and decreased specificity for all tests. In contrast, when combined in series, these tests demonstrated increased specificity and decreased sensitivity. Conclusion: This study shows the need to use multiple tests to evaluate tear film quality and include a symptom questionnaire as part of the diagnostic algorithm for dry eye disease.</p></div

Keratoconjunctivitis sicca of human T cell lymphotropic virus type 1 (HTLV-1) infected individuals is associated with high levels of HTLV-1 proviral load

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2014-07-25T17:19:41Z No. of bitstreams: 1 Vargens CLV Keratoconjunctivitis sicca....pdf: 198431 bytes, checksum: fccb0e7cfe2c79a57fee556ace0172ef (MD5)Made available in DSpace on 2014-07-25T17:19:42Z (GMT). No. of bitstreams: 1 Vargens CLV Keratoconjunctivitis sicca....pdf: 198431 bytes, checksum: fccb0e7cfe2c79a57fee556ace0172ef (MD5) Previous issue date: 2011Instituto Brasileiro de Oftalmologia e Prevenção da Cegueira. IBOPC. Salvador, BA, Brasil.Centro Integrativo e Multidisciplinar de HTLV. Escola Bahiana de Medicina e Saúde Pública. EBMSP. Salvador, BA, Brasil.Centro Integrativo e Multidisciplinar de HTLV. Escola Bahiana de Medicina e Saúde Pública. EBMSP. Salvador, BA, Brasil.Instituto Brasileiro de Oftalmologia e Prevenção da Cegueira. IBOPC. Salvador, BA, Brasil / Centro Integrativo e Multidisciplinar de HTLV. Escola Bahiana de Medicina e Saúde Pública. EBMSP. Salvador, BA, Brasil.Centro Integrativo e Multidisciplinar de HTLV. Escola Bahiana de Medicina e Saúde Pública. EBMSP. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Laboratório Avançado de Saúde .Pública. Salvador, BA, BrasilInstituto Brasileiro de Oftalmologia e Prevenção da Cegueira. IBOPC. Salvador, BA, Brasil.Centro Integrativo e Multidisciplinar de HTLV. Escola Bahiana de Medicina e Saúde Pública. EBMSP. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, Brasil.BACKGROUND: A high HTLV-1 proviral load is found in HTLV-1-associated diseases, mainly HAM/TSP. However, the association between proviral load and keratoconjunctivitis sicca (KCS) has not been well established. AIM: To verify the association between KCS and HTLV-1 proviral load. STUDY DESIGN: 104 HTLV-1 infected patients (51 asymptomatic and 52 with HAM/TSP) from the HTLV reference center in Salvador, Brazil were followed from June 2008 to May 2010. Evaluation of tear secretion was performed by BUT (break-up time), Rose Bengal and Schirmer I tests. The diagnosis of KCS was based upon the presence of symptoms and when at least two of three tests were positive. HTLV-1 proviral load was determined using real-time PCR. RESULTS: The prevalence of KCS was 44.2%. KCS was more frequent among HAM/TSP patients (p = 0.022). Patients with KCS had higher proviral load (mean 134,672 ± 150,393copies/10(6) PBMC) than patients without the disease (mean 66,880 ± 109,525copies/10(6) PBMC) (p = 0.001). HTLV-1 proviral load>100,000copies/10(6) PBMC increased significantly the risk of developing KCS (OR = 4.05 and 95% CI = 1.40-11.76). After age>45 years and HAM/TSP status were excluded in stepway reward analysis, the variables PVL>100,000 (OR = 4.77 and 95% CI = 1.83-12.44) still remained statistically significant. CONCLUSION: HTLV-1 proviral loads are higher in patients with KCS and may represent a relevant biological marker of disease