Corneal Toxicity Associated With Aquarium Coral Palytoxin

Asim V. Farooq, Allister G. Gibbons, Matthew D. Council, George J. Harocopos, Simon Holland, Jeffrey Judelson, Bradley L. Shoss, Eric J. Schmidt, Umi Kalthum Md Noh, Alexander D'Angelo, Rao V. Chundury, Richard Judelson, Victor L. Perez, Andrew J W Huang

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Purpose To report a series of patients who developed corneal toxicity after exposure to aquarium coral palytoxin. Design Multicenter retrospective case series. Methods Retrospective review. Results Seven patients presented with corneal findings ranging from superficial punctate epitheliopathy to bilateral corneal melt with subsequent perforation. Among those with mild corneal findings, resolution was achieved with topical steroids and lubrication, whereas some patients who developed progressive corneal melt required therapeutic penetrating keratoplasty. The history in all patients revealed exposure to aquarium zoanthid corals shortly before disease onset. A review of the literature revealed that there are few prior reports of coral-associated corneal toxicity and that some species of coral secrete a substance known as palytoxin, a potent vasoconstrictor that inhibits the membranous sodium-potassium ATPase pump across cell types and can cause rapid death if inhaled or ingested. Conclusions This is the largest case series to date demonstrating patients with aquarium coral palytoxin–associated corneal toxicity, and is the first to provide details of related histopathologic findings. Similar to other forms of toxic keratoconjunctivitis, a detailed history and careful clinical assessment are required, as well as timely removal of the offending agent from the patients' ocular milieu and environment. Mild ocular surface and corneal disease may be treated effectively with aggressive topical steroid therapy and lubrication. Given the potential severity of ocular as well as systemic adverse effects, there should be increased awareness of this entity among eye care professionals, aquarium enthusiasts, and the general public.

Original languageEnglish
Pages (from-to)119-125
Number of pages7
JournalAmerican Journal of Ophthalmology
Volume174
DOIs
Publication statusPublished - 1 Feb 2017

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Anthozoa
Lubrication
History
Steroids
Corneal Diseases
Keratoconjunctivitis
Sodium-Potassium-Exchanging ATPase
Penetrating Keratoplasty
Eye Diseases
Poisons
Proxy
Vasoconstrictor Agents
Cause of Death
palytoxin
Therapeutics

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Farooq, A. V., Gibbons, A. G., Council, M. D., Harocopos, G. J., Holland, S., Judelson, J., ... Huang, A. J. W. (2017). Corneal Toxicity Associated With Aquarium Coral Palytoxin. American Journal of Ophthalmology, 174, 119-125. https://doi.org/10.1016/j.ajo.2016.10.007

Corneal Toxicity Associated With Aquarium Coral Palytoxin. / Farooq, Asim V.; Gibbons, Allister G.; Council, Matthew D.; Harocopos, George J.; Holland, Simon; Judelson, Jeffrey; Shoss, Bradley L.; Schmidt, Eric J.; Md Noh, Umi Kalthum; D'Angelo, Alexander; Chundury, Rao V.; Judelson, Richard; Perez, Victor L.; Huang, Andrew J W.

In: American Journal of Ophthalmology, Vol. 174, 01.02.2017, p. 119-125.

Research output: Contribution to journalArticle

Farooq, AV, Gibbons, AG, Council, MD, Harocopos, GJ, Holland, S, Judelson, J, Shoss, BL, Schmidt, EJ, Md Noh, UK, D'Angelo, A, Chundury, RV, Judelson, R, Perez, VL & Huang, AJW 2017, 'Corneal Toxicity Associated With Aquarium Coral Palytoxin', American Journal of Ophthalmology, vol. 174, pp. 119-125. https://doi.org/10.1016/j.ajo.2016.10.007
Farooq AV, Gibbons AG, Council MD, Harocopos GJ, Holland S, Judelson J et al. Corneal Toxicity Associated With Aquarium Coral Palytoxin. American Journal of Ophthalmology. 2017 Feb 1;174:119-125. https://doi.org/10.1016/j.ajo.2016.10.007
Farooq, Asim V. ; Gibbons, Allister G. ; Council, Matthew D. ; Harocopos, George J. ; Holland, Simon ; Judelson, Jeffrey ; Shoss, Bradley L. ; Schmidt, Eric J. ; Md Noh, Umi Kalthum ; D'Angelo, Alexander ; Chundury, Rao V. ; Judelson, Richard ; Perez, Victor L. ; Huang, Andrew J W. / Corneal Toxicity Associated With Aquarium Coral Palytoxin. In: American Journal of Ophthalmology. 2017 ; Vol. 174. pp. 119-125.
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