June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Toxic keratopathy due to zoanthid coral palytoxin
Author Affiliations & Notes
  • Asim Visal Farooq
    Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois, United States
  • Allister Gibbons
    University of Miami, Miami, Florida, United States
  • Matthew Council
    St. Louis University, St. Louis, Missouri, United States
  • George J Harocopos
    Washington University in St. Louis, St. Louis, Missouri, United States
  • Simon Holland
    University of British Columbia, Vancouver, British Columbia, Canada
  • Jeffrey Judelson
    Pasqua Hospital, Regina, Saskatchewan, Canada
  • Bradley Shoss
    Washington University in St. Louis, St. Louis, Missouri, United States
  • Eric Schmidt
    St. Louis University, St. Louis, Missouri, United States
  • Umi Md Noh
    University of British Columbia, Vancouver, British Columbia, Canada
    National University of Malaysia, Bangi, Malaysia
  • Alexander D’Angelo
    St. Louis University, St. Louis, Missouri, United States
  • Rao Chundury
    St. Louis University, St. Louis, Missouri, United States
  • Richard Judelson
    Pasqua Hospital, Regina, Saskatchewan, Canada
  • Victor L Perez
    University of Miami, Miami, Florida, United States
  • Andrew J W Huang
    Washington University in St. Louis, St. Louis, Missouri, United States
  • Footnotes
    Commercial Relationships   Asim Farooq, None; Allister Gibbons, None; Matthew Council, None; George Harocopos, None; Simon Holland, None; Jeffrey Judelson, None; Bradley Shoss, None; Eric Schmidt, None; Umi Md Noh, None; Alexander D’Angelo, None; Rao Chundury, None; Richard Judelson, None; Victor Perez, None; Andrew Huang, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5165. doi:
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      Asim Visal Farooq, Allister Gibbons, Matthew Council, George J Harocopos, Simon Holland, Jeffrey Judelson, Bradley Shoss, Eric Schmidt, Umi Md Noh, Alexander D’Angelo, Rao Chundury, Richard Judelson, Victor L Perez, Andrew J W Huang; Toxic keratopathy due to zoanthid coral palytoxin. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5165.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To describe a series of patients that developed toxic keratopathy shortly after exposure to zoanthid coral.

Methods : Retrospective, multi-center case review.

Results : The corneal findings in seven patients exposed to aquarium coral palytoxin ranged from a mild reversible epitheliopathy to severe keratolysis and perforation. Treatment most commonly included topical steroids and topical antibiotics; in some cases, oral doxycycline, oral prednisone, amniotic membrane transplantation, corneal gluing, and/or corneal transplantation were employed. All patients provided a history of exposure to zoanthid corals, although in some cases this history was not elicited at the time of initial presentation. A review of the literature revealed that palytoxin is one of the most lethal substances in the world, and exposure can lead to severe systemic effects including respiratory failure and death.

Conclusions : Zoanthid coral palytoxin is a potential cause of severe toxic keratopathy. In patients presenting with signs suggesting a toxic exposure but without a clear etiology, a thorough history should include whether there has been recent contact with zoanthid coral species. Treatment should include aggressive anti-inflammatory medications, with a high index of suspicion for secondary infection. We recommend the use of personal protective equipment, including goggles and gloves, while handling zoanthid coral species.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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