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Photo Essay |

Chorioretinitis With Late Pigmentary Changes in a Carrier of Human T-Lymphotropic Virus 1

Nagakazu Matsumura, MD; Miki Sawa, MD; Nobuyuki Ohguro, MD; Kazuki Kuniyoshi, MD; Yasuo Tano, MD
Arch Ophthalmol. 2007;125(10):1436. doi:10.1001/archopht.125.10.1436.
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A 41-year-old woman who is a carrier of human T-lymphotropic virus 1 (HTLV-1) experienced a decrease in the vision of her left eye in 2002. A large, deep, pale, slightly thickened lesion with brown pigment (Figure 1A) and lobular leakage hyperfluorescence and punctate hypofluorescence (Figure 1B and C) developed in June 2002. Some lesions fused 1 week later (Figure 1D-F). Six weeks after symptom onset, visual acuity in the left eye improved to 20/20. The lesions showed pigment proliferation (Figure 1G) and leakage resolved (Figure 1H); however, peculiar hypofluorescence developed (Figure 1I). Six months after symptom onset, brown pigment proliferation, subretinal fibrosis, and peripheral pigmentary streaks developed (Figure 2). Visual acuity remained 20/20 OS at the last follow-up visit in 2006.

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Figure 1.

Color and angiographic images of the left eye in a 41-year-old woman who is a carrier of human T-lymphotropic virus 1. A, A large lesion with brown pigment is visible superotemporally with surrounding lesions (visual acuity [VA], 20/30). B and C, Fluorescein angiography (FA) shows diffuse leakage. Hypofluorescence indicates pigment proliferation (C, arrow). D, One week later, round and oval macular lesions have developed and some have fused; pigmentation has increased (VA, 20/50). E and F, On FA, leakage has increased in the large lesion (F, arrows). Each lesion has also expanded (arrowhead). G, Six weeks after symptom onset, the lesions have changed color (VA, 20/20). H, Fluorescein angiography shows a reticular pattern in the posterior pole and hypofluorescent spots. I, Indocyanine green angiography shows hypofluorescence within the lesions.

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Figure 2.

Panoramic fundus view 6 months after symptom onset. Subretinal fibrosis has developed in the macula and pigmentary streaks have developed in the periphery. The lesions are accompanied by brown pigment proliferation.

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