Dangerous reef aquaristics: Palytoxin of a brown encrusting anemone causes toxic corneal reactions

Abstract

Although frequently observed in domestic saltwater aquariums, literature on exposure to palytoxin (PTX) of encrusting anemones (Zoanthidea) kept in aquariums is rare. Handling these animals for propagation purposes or during cleaning work can lead to dermal, ocular or respiratory contact with the PTX generated by some Zoanthids. The present study describes a case of ocular exposure to liquid from a Zoanthid, which led to corneal ulcers. The patient also suffered from systemic symptoms of dyspnea and shivering and a suspected rhabdomyolysis, which required monitoring in the Intensive Care Unit. After symptomatic treatment provided insufficient results, the corneal ulcers improved with an amniotic membrane transplantation. A review of the literature regarding ocular exposures to this diverse order of Hexacorallia reveals that severe and systemic symptoms can develop with minimal contact. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Human Poisoning from Marine Toxins: Unknowns for Optimal Consumer Protection

“…The patients display keratoconjuntivitis, eye pain, photophobia and decreased vision. In more serious cases, corneal ulcer, dyspnea, nausea and shivering may occur [ 240 , 241 , 242 ].…”

Palytoxin-Containing Aquarium Soft Corals as an Emerging Sanitary Problem

“…Although ocular exposure is one of the less predictable exposure routes for PLTX, cases of eye irritation, mainly keratoconjunctivitis, occurred after the contact with mucous secretions from soft corals [ 59 , 60 ].…”

“…The cornea healed after several weeks, with residual thinning, while the remaining irregular corneal astigmatism was corrected four months later fitting scleral contact lenses. Then, visual acuity recovered to 0.8 in the right eye and 1.0 in the left eye [ 60 ].…”

“…The clinical course, the duration of symptoms, and the treatment were always unknown, except for few cases in which symptoms resolved between four days and seven months after exposure. Signs and symptoms were often treated rinsing the eyes with water, administering artificial tears, steroids drops, and/or antibiotics, while in one case the patient used contact lenses for four years after exposure to correct the vision [ 60 ].…”

Characterisation of palytoxin from an undescribed Palythoa (Anthozoa: Zoantharia: Sphenopidae) with significant in vitro cytotoxic effects on cancer cells at picomolar doses

“…outbreaks [12], there is a need for high-yield sources of PlTX so as to facilitate its functional characterisation. 3 Sales from aquarium trade of zoanthids containing PlTX have also caused domestic intoxications after inhalation of steam [13,14], dermal contact [15] or water spray in the eyes [16,17].…”