Corneal Toxicity Following Exposure to Asclepias Tuberosa



Lauge Hjorth Mikkelsen1, Hassan Hamoudi2, Cigdem Altuntas Gül2, Steffen Heegaard1, 2, *
1 Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
2 Department of Ophthalmology, Rigshospitalet, Copenhagen University Hospital, Glostrup, Denmark


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© Mikkelsen et al.; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this authors at the Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Frederik V’s vej 11 4. Sal, 2100 København Ø, Denmark; Tel: +45 35326071; E-mail: sthe@sund.ku.dk


Abstract

Purpose:

To present a case of corneal toxicity following exposure to milky plant latex from Asclepias tuberosa.

Methods:

A 70-year-old female presented with blurred vision and pain in her left eye after handling an Ascepias tuberosa. Clinical examination revealed a corneal stromal oedema with small epithelial defects. The corneal endothelium was intact and folds in Descemets membrane were observed. The oedema was treated with chloramphenicol, dexamethasone and scopolamine.

Results:

The corneal oedema had appeared after corneal exposure to the plant, Asclepias tuberosa, whose latex contains cardenolides that inhibit the Na+/ K+-ATPase in the corneal endothelium. The oedema resolved after 96 hours. After nine months the best corrected visual acuity was 20/20.

Conclusion:

Corneal toxicity has previously been reported for plants of the Asclepias family. This is a rare case describing severe corneal toxicity caused by exposure to latex from Asclepias tuberosa. Handling of plants of the Asclepias family should be kept as a differential diagnosis in cases of acute corneal toxicity.

Keywords: Cornea, Asclepias, Corneal oedema, Corneal toxicity.