Combine the chopped fish, parmesan, mayonnaise, egg (if using,) coconut flour (if using,) mustard, Worcestershire, Creole seasoning and fresh parsley in a medium-sized bowl. Stir well until fully mixed.
Heat the oil in a non stick sauce pan over medium high heat until shimmering.
Form the fish mixture into 8 patties, about 2 inches in diameter.
Fry the patties in batches for about 2 minutes per side (turn gently,) or until golden brown on the outside and cooked through.
Serve warm with the salsa from below.
To make the roasted red pepper salsa:
Combine the chopped peppers, parsley, garlic, onion, olive oil, lemon juice, and sweetener in a small bowl.
Stir well to mix.
Store any leftovers in the refrigerator for up to one week.