Gray-White, Spherical Deposition on Retinal Vessel Associated With Acute Retinal Necrosis and Diabetic Retinopathy in HTLV-I Carriers

Abstract Tiny, gray-white, spherical deposits were found on the retinal vessels and vitreoretinal interface of the fovea in a 55-year-old woman with acute retinal necrosis due to varicella-zoster virus, and in a 47-year-old man with preproliferative diabetic retinopathy. Both patients developed massive vitreous opacities due to uveal inflammation or hemorrhages that rendered the fundus difficult to visualize. A therapeutic vitrectomy revealed gray-white, tiny spherical deposits, about blood-vessel–diameter, which were scattered on seemingly intact retinal arteries and veins in the posterior fundus and over the vitreoretinal interface overlying the fovea. The deposits were loosely adherent to vessel walls and were easily aspirated, and the residual materials resolved in the early postoperative days. These characteristic retinal vascular deposits resembled those seen in patients with HTLV-I associated uveitis. The two patients reported herein were otherwise asymptomatic carriers of HTLV-I. The findings provide additional information about the etiological role of HTLV-I in the development of characteristic retinal vascular deposition, although its pathogenesis remains to be elucidated.