Barrett Ryan T, Hastings Jordan P, Ronquillo Yasmyne C, Hoopes Phillip C, Moshirfar Majid
Hollingshead Eye Center, Boise, ID, USA.
California Northstate University College of Medicine, Elk Grove, CA, USA.
Clin Ophthalmol. 2021 Jan 12;15:141-156. doi: 10.2147/OPTH.S290455. eCollection 2021.
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.
岩沙海葵毒素是迄今发现的最致命的天然毒素之一。这种分子已从包括海葵珊瑚在内的各种海洋动物中分离出来。这种受欢迎的生物因其美丽和生存能力，常见于许多家庭的海水水族箱中。由于其受欢迎程度增加，越来越多的人面临接触这种潜在致命毒素的风险。受影响的患者可能会根据接触途径（即皮肤接触、吸入雾化毒素、眼部接触或摄入）出现各种症状。眼部接触可通过多种方式发生（例如，接触受污染的水、用脏手揉眼睛或直接喷入眼睛），近年来发病率急剧上升。在本综述中，我们讨论了一例因吸入和眼部接触疑似来自海葵珊瑚的岩沙海葵毒素而导致全身中毒的病例，该病例导致患者入住重症监护病房（ICU），并出现角膜穿孔，需要进行角膜移植。此外，我们回顾了关于这种毒素作用机制的已知信息，提出了其对角膜细胞影响的综合假设，并讨论了因其他接触途径继发全身症状的患者的预后和临床管理。
