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Vol. 94. Issue 4.
Pages 184-187 (April 2019)
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Vol. 94. Issue 4.
Pages 184-187 (April 2019)
Short communication
Toxic corneal reaction due to exposure to palytoxin
Toxicidad corneal por exposición a palitoxina
Visits
19
M. Barbanya,b,
Corresponding author
miriambarbany@hotmail.com

Corresponding author.
, M. Rossella, A. Salvadora
a Departamento Oftalmología, Hospital Universitario Mútua de Terrassa, Terrassa, Spain
b Departamento de Segmento Anterior, Instituto Microcirugía Ocular, Barcelona, Spain
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Abstract

A case is presented of corneal toxicity after exposure to palytoxin. A 42 year-old man came with symptoms of pain and blurred vision in his right eye. He reported that a zoanthid coral from a saltwater aquarium had squirted into his eye. Slit-lamp examination showed a prominent central ring infiltrate of 4×6mm without epithelial defect and satellite sub-epithelial micro-infiltrates. After 2 months of topical treatment with steroids, the stromal ring infiltrate was resolved, but a stromal thinning and residual fibrosis remained. Palytoxin is a potent vasoconstrictor that damages the ionic gradient of the cells, causing cell death. It is crucial to remove the toxin and start an aggressive topical therapy as soon as possible. In addition, considering the potential ocular and systemic adverse effects that this toxin can produce, it would be advisable to inform people of its existence and regulate the distribution of this type of corals.

Keywords:
Palytoxin
Toxic keratoconjunctivitis
Corneal melt
Toxin
Coral
Zoanthid
Aquarium
Resumen

Describir un caso de toxicidad corneal secundaria a exposición a palitoxina. Un hombre de 42 años acude por dolor y visión borrosa en su ojo derecho de una semana de evolución. Como antecedente destaca la entrada de un líquido procedente de un coral (Palythoa sp). En la biomicroscopia se observa un infiltrado central en forma de anillo de 4×6mm sin defecto epitelial y con microinfiltrados subepiteliales satélites. Después de 2 meses de tratamiento tópico con esteroides se resuelve el infiltrado, pero persiste una fibrosis y adelgazamiento estromal paracentral. La palitoxina es un potente vasoconstrictor que daña el gradiente iónico de las células provocando muerte celular. Es crucial retirar la toxina e iniciar una terapia intensiva con corticoides tópicos lo antes posible. Asimismo, teniendo en cuenta los efectos adversos oculares y sistémicos, sería conveniente informar a la población de su existencia y regular la distribución de este tipo de corales.

Palabras clave:
Palitoxina
Queratoconjuntivitis tóxica
Infiltrado corneal
Toxina
Coral
Zoántido
Acuario

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