Coral Keratitis: Case Report and Review of Mechanisms of Action, Clinical Management and Prognosis of Ocular Exposure to Palytoxin

Ryan T Barrett,1 Jordan P Hastings,2 Yasmyne C Ronquillo,3 Phillip C Hoopes,3 Majid Moshirfar3– 5 1Hollingshead Eye Center, Boise, ID, USA; 2California Northstate University College of Medicine, Elk Grove, CA, USA; 3Hoopes Vision Research Center, Draper, UT, USA; 4John A. Moran Eye Center,...

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Autores principales:	Barrett RT, Hastings JP, Ronquillo YC, Hoopes PC, Moshirfar M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	coral keratitis zoanthid palytoxin corneal perforation case report Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/2eecf609695d44689f1621db9d6f49f9
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spelling	oai:doaj.org-article:2eecf609695d44689f1621db9d6f49f92021-12-02T14:01:50ZCoral Keratitis: Case Report and Review of Mechanisms of Action, Clinical Management and Prognosis of Ocular Exposure to Palytoxin1177-5483https://doaj.org/article/2eecf609695d44689f1621db9d6f49f92021-01-01T00:00:00Zhttps://www.dovepress.com/coral-keratitis-case-report-and-review-of-mechanisms-of-action-clinica-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Ryan T Barrett,1 Jordan P Hastings,2 Yasmyne C Ronquillo,3 Phillip C Hoopes,3 Majid Moshirfar3– 5 1Hollingshead Eye Center, Boise, ID, USA; 2California Northstate University College of Medicine, Elk Grove, CA, USA; 3Hoopes Vision Research Center, Draper, UT, USA; 4John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA; 5Utah Lions Eye Bank, Murray, UT, USACorrespondence: Majid MoshirfarHDR Research Center, Hoopes Vision, 11820 S. State Street Suite #200, Draper, UT, USATel +1 801-568-0200Email Cornea2020@me.comAbstract: Palytoxin is one of the most lethal natural toxins ever discovered. This molecule has been isolated from various marine animals, including zoanthid corals. This popular organism is commonly found in many home saltwater aquariums due to its beauty and survivability. As a result of an increase in popularity, an increased number of individuals are at risk for exposure to this potentially deadly toxin. Affected patients may experience various symptoms based on the route of exposure (ie, cutaneous contact, inhalation of aerosolized toxin, ocular exposure, or ingestion). Ocular exposure can occur in various ways (eg, contact with contaminated water, rubbing the eye with a dirtied hand, or direct spraying into the eye), and incidence rates have dramatically risen in recent years. In this review, we discuss a case of systemic toxicity from inhalation and ocular exposure to presumed palytoxin on a zoanthid coral which resulted in an intensive care unit (ICU) stay, and corneal perforation which required a corneal transplant. Additionally, we review what is known about the mechanism of action of this toxin, propose a comprehensive hypothesis of its effects on corneal cells, and discuss the prognosis and clinical management of patients with systemic symptoms secondary to other routes of exposure.Keywords: coral keratitis, zoanthid, palytoxin, corneal perforation, case reportBarrett RTHastings JPRonquillo YCHoopes PCMoshirfar MDove Medical Pressarticlecoral keratitiszoanthidpalytoxincorneal perforationcase reportOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 141-156 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	coral keratitis zoanthid palytoxin corneal perforation case report Ophthalmology RE1-994
spellingShingle	coral keratitis zoanthid palytoxin corneal perforation case report Ophthalmology RE1-994 Barrett RT Hastings JP Ronquillo YC Hoopes PC Moshirfar M Coral Keratitis: Case Report and Review of Mechanisms of Action, Clinical Management and Prognosis of Ocular Exposure to Palytoxin
description	Ryan T Barrett,1 Jordan P Hastings,2 Yasmyne C Ronquillo,3 Phillip C Hoopes,3 Majid Moshirfar3– 5 1Hollingshead Eye Center, Boise, ID, USA; 2California Northstate University College of Medicine, Elk Grove, CA, USA; 3Hoopes Vision Research Center, Draper, UT, USA; 4John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA; 5Utah Lions Eye Bank, Murray, UT, USACorrespondence: Majid MoshirfarHDR Research Center, Hoopes Vision, 11820 S. State Street Suite #200, Draper, UT, USATel +1 801-568-0200Email Cornea2020@me.comAbstract: Palytoxin is one of the most lethal natural toxins ever discovered. This molecule has been isolated from various marine animals, including zoanthid corals. This popular organism is commonly found in many home saltwater aquariums due to its beauty and survivability. As a result of an increase in popularity, an increased number of individuals are at risk for exposure to this potentially deadly toxin. Affected patients may experience various symptoms based on the route of exposure (ie, cutaneous contact, inhalation of aerosolized toxin, ocular exposure, or ingestion). Ocular exposure can occur in various ways (eg, contact with contaminated water, rubbing the eye with a dirtied hand, or direct spraying into the eye), and incidence rates have dramatically risen in recent years. In this review, we discuss a case of systemic toxicity from inhalation and ocular exposure to presumed palytoxin on a zoanthid coral which resulted in an intensive care unit (ICU) stay, and corneal perforation which required a corneal transplant. Additionally, we review what is known about the mechanism of action of this toxin, propose a comprehensive hypothesis of its effects on corneal cells, and discuss the prognosis and clinical management of patients with systemic symptoms secondary to other routes of exposure.Keywords: coral keratitis, zoanthid, palytoxin, corneal perforation, case report
format	article
author	Barrett RT Hastings JP Ronquillo YC Hoopes PC Moshirfar M
author_facet	Barrett RT Hastings JP Ronquillo YC Hoopes PC Moshirfar M
author_sort	Barrett RT
title	Coral Keratitis: Case Report and Review of Mechanisms of Action, Clinical Management and Prognosis of Ocular Exposure to Palytoxin
title_short	Coral Keratitis: Case Report and Review of Mechanisms of Action, Clinical Management and Prognosis of Ocular Exposure to Palytoxin
title_full	Coral Keratitis: Case Report and Review of Mechanisms of Action, Clinical Management and Prognosis of Ocular Exposure to Palytoxin
title_fullStr	Coral Keratitis: Case Report and Review of Mechanisms of Action, Clinical Management and Prognosis of Ocular Exposure to Palytoxin
title_full_unstemmed	Coral Keratitis: Case Report and Review of Mechanisms of Action, Clinical Management and Prognosis of Ocular Exposure to Palytoxin
title_sort	coral keratitis: case report and review of mechanisms of action, clinical management and prognosis of ocular exposure to palytoxin
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/2eecf609695d44689f1621db9d6f49f9
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Coral Keratitis: Case Report and Review of Mechanisms of Action, Clinical Management and Prognosis of Ocular Exposure to Palytoxin

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