Duration 5min, Q&A 3min
Exfoliation Syndrome and Human T-Lymphotropic Virus Type 1
The onset of exfoliation syndrome (XFS) may be influenced not only by genetic factors but also by environmental factors or infection.
In contrast to China, where XFS is rare, Japan has a moderate prevalence of XFS with significant LOXL1 gene variants.
In Kyushu, the southernmost island, the prevalence of XFS (3.4%), is higher than in the other major islands.1 Detorakis2 suggested herpes virus infection may be involved in the occurrence of exfoliation glaucoma (XFG). Human T-lymphotropic virus type 1 (HTLV-1) causes several diseases such as Human T cell leukemia, HTLV-1-associated myelopathy and HTLV-1-associated uveitis. Japan has a high prevalence of HTLV-1 carriers, in contrast to a very low prevalence in China.3 Kyushu has a higher prevalence of HTLV-1 carriers than in other major islands.The epidemiological distribution of HTLV-1 carriers seems to correlate with the distribution of XFS in Japan. The aim of this study was to compare the prevalence of HTLV-1 carriers between XFS and non-XFS patients.
A total of 229 Japanese participants were recruited from the outpatient clinic of Ozaki Eye Hospital in Hyuga, Kyushu, Japan. We studied 160 patients (58 male, 102 female) with XFS including XFG and 69 controls (28 male, 41 female) without XFS. The mean (±standard deviation) age of XFS cases was 79.9±6.33 years. The mean age of non-XFS cases was 75.2±7.02 years.
All subjects underwent standard ophthalmic examination. No presence of exfoliation material on the lens surface was confirmed after dilation in non-XFS subjects. Blood samples were taken from the subjects and analyzed by chemiluminescent immunoassay (CLIA).
Results and Conclusion
In the XFS/XFG group, HTLV-1 was positive in 21 cases (13%, 5 male). In the non-XFS group, HTLV-1 was positive in 6 cases (8.7%, 1 male). There was no statistically significant difference in the prevalence of HTLV-1 carriers between the two groups (p=0.341).
In this study, there was no statistically significant difference in the prevalence of HTLV-1 carriers between XFS/XFG subjects and non-XFS subjects in Kyushu, Japan. Future pathological investigation of iris specimens in XFG may further clarify any relationship between HTLV-1 in XFS/XFG.
1. Miyazaki et al. J Glaucoma 2005
2. Detorakis, E. T. et al. Detection of herpes simplex virus in pseudoexfoliation syndrome and exfoliation glaucoma. Acta Ophthalmol Scand. 2002
3. Hinuma, Y. et al. Adult T-cell leukemia: Antigen in an ATL cell line and detenction of antibodies to the antigen in human sera. Proc. Natl. Acad. Sci. 1981
[ Keyword ]
Exfoliation Syndrome / Human T-lymphotropic virus type 1 / Glaucoma
[ Conflict of Interest ]