| 본문 : Background: To introduce a case of corneal endothelial toxicity caused by Asclepias curassavica (Milkweed) in a young patient that was successfully treated with aggressive anti-inflammatory treatment.
Case Presentation A 37-year-old Asian man presented with decreased vision and redness in the right eye, which developed after contact with Asclepias curassavica. At presentation, best-corrected visual acuity (BCVA) was 20/60 in the right eye. Slit lamp examination demonstrated severe corneal stromal edema with Descemet’s folds and conjunctival hyperemia. We prescribed topical prednisolone acetate 1% eye drops (8 times a day), cyclosporine 0.1% (once a day) and oral prednisolone (30 mg a day for 3 days). One day later, the BCVA improved to20/40 and marked improvement in corneal edema was observed. At 5 days, BCVA was 20/22 and anterior segment examination showed minimal corneal edema with resolution of Descemet’s folds. At 2 weeks, BCVA was 20/20 in the right eye and corneal edema completely resolved.
Conclusions: High index of suspicion and detailed history taking regarding toxicity from Asclepias species when encountered with patients who present with corneal edema after handling plants. Aggressive anti-inflammatory treatment might be helpful for early recovery, at least for young patients. |