Pitts J F, Barker N H, Gibbons D C, Jay J L
Tennent Institute of Ophthalmology, Glasgow, Scotland.
Br J Ophthalmol. 1993 May;77(5):284-8. doi: 10.1136/bjo.77.5.284.
The Manchineel tree is an evergreen widely distributed in tropical regions. The toxic nature of Manchineel has been known since the early sixteenth century. Contact with its milky sap (latex) produces bullous dermatitis and acute keratoconjunctivitis. We identified 19 patients who had ocular injuries caused by Manchineel between 1985 and 1990 and were able to review 12. All of these patients had been treated by lavage, cycloplegia, and topical antibiotics. Of 20 episodes of exposure 14 affected both eyes. The cornea was damaged in 16 episodes, the extent varying from large corneal epithelial defects to superficial punctate keratitis. The epithelial changes had resolved in a mean period of 3.75 days (range 1 to 14 days). Two episodes caused stromal infiltration to appear and in one of these a stromal opacity remained 5 years later. The final visual acuity was 6/9 or better in all eyes except in one patient who had visual impairment because of glaucoma. Our results suggest that despite the severity of the acute reaction, the long term visual prognosis is excellent in Manchineel keratoconjunctivitis. The historical and toxicological literature on Manchineel is reviewed.
毒番石榴树是一种广泛分布于热带地区的常绿植物。自16世纪初以来，人们就知道毒番石榴树有毒。接触其乳白色汁液（乳胶）会引发大疱性皮炎和急性角膜结膜炎。我们确定了19例在1985年至1990年间因毒番石榴树导致眼部受伤的患者，并对其中12例进行了复查。所有这些患者均接受了冲洗、睫状肌麻痹和局部抗生素治疗。在20次接触事件中，14次双眼均受到影响。16次事件中角膜受损，程度从大面积角膜上皮缺损到浅层点状角膜炎不等。上皮变化平均在3.75天（范围1至14天）内消退。两次事件导致基质浸润出现，其中一次5年后仍有基质混浊。除一名因青光眼导致视力受损的患者外，所有患者的最终视力均为6/9或更好。我们的结果表明，尽管急性反应严重，但毒番石榴树引起的角膜结膜炎的长期视力预后良好。本文对毒番石榴树的历史和毒理学文献进行了综述。
