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Corneal Toxicity Following Exposure to Asclepias Tuberosa
Lauge Hjorth Mikkelsen1, Hassan Hamoudi2, Cigdem Altuntas Gül2
1Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
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.