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K. Matsumoto, T. Okuda, S. Miyajima, H. Tanihara; Corneal Lesions Caused by Gomphocarpus Fruticosus . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4750.
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Purpose: To describe corneal lesions caused by an herb, Gomphocarpus fruticosus and to determine if its fluid (extract) can cause similar lesions in rabbit eyes Methods: The medical records were retrospectively evaluated with regard to symptoms, signs, treatment modality and prognosis in 15 eyes of 7 cases. The cases included 3 males and 4 females and ranged in age from 51 to 78 years (average: 67.1 years). Two cases had at least 2 episodes. A 50 µl of herbal extract was instilled into the right eyes of 6 albino rabbits anesthetized with topical oxybuprocaine. A sterile physiological saline was instilled into the left eyes as a control. Corneal lesions were observed and photographed at 6, 12 and 24 hours after instillation, and the excised corneas were processed for histological examination. Results: Major symptoms included blurred vision (60%), conjunctival injection (60%), lacrimation (53.3%) and ocular pain (46.7%). Signs included folds in Descemet's membrane (93.3%), corneal edema (26.7%), superficial punctate keratopathy (26.7%) and iritis 6.7%). These lesions responded well to a topical corticosteroid therapy combined with anti-microbial agents and healed within 2 weeks. In rabbit eyes, similar corneal lesions were elicited by the herbal extract. Histological examination disclosed marked swelling of the corneal stroma, irregularity of corneal epithelium and inflammatory cell infiltration in the stroma. However, no appreciable morphological changes were observed in the corneal endothelium light microscopically even at 24 hours after instillation. Conclusions: Corneal lesions caused by Gomphocarpus fruticosus could be attributable to its extracts that contain cardiac glycoside-like substances. The substances can disturb Na+/K+_ATPase pump of the corneal endothelium resulting in marked corneal swelling.
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