A 66-year-old woman was referred to our department with a one-year history of right eye uveitis.
The patient reported decreased vision in that eye but did not have myodesopsias or metamorphopsias.
His past medical history revealed that twelve years ago he had suffered an intracranial hemorrhage that required surgical intervention and transfusion of two units of concentrated catheters.
The best corrected visual acuity (BCVA) was 8/20 in the right eye and 10/20 in the left eye.
In the helmet-lamp examination, vitreous cell remnants were observed without signs of activity.
The fundus examination revealed an epimacular membrane in both eyes, with no signs of vasculitis, or the presence of snowballs or snowbanks.
Optical coherence tomography confirmed the epimacular membrane.
She was diagnosed with intermediate uveitis of unknown etiology.
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In the following months, the patient developed progressive weakness in the lower limbs, leading to the development of disability to walk.
She also consulted for an episode of seizures associated with triamcinolone transeptal (TRIGON depot).
In the etiological study, after ruling out other causes of the neurological picture, with normal nuclear magnetic resonance, in the association of uveitis and idiopathic myelopathy with patellar hyperreflexia HTLV-HTBO positive antibodies was requested.
EIA samples were analyzed by strip immunoblot (INNO-LIATM HTLV I/II, Innogenetics N.V.) which confirmed the presence of HTLV-1 antibodies.
The diagnosis of tropical spastic paraparesis and intermediate uveitis by HTLV-1 was established.
She was treated with oral prednisone, improving her neurological symptoms as well as her BCVA, achieving a vision of 14/20 in right eye and 18/20 in left eye.
