Medicine and Health Sciences Commons^™

Vascular, Immunological, And Mechanical Factors In Normal Tension Glaucoma: A Multidimensional Approach To Pathogenesis, Rachel E. Cain

inSIGHT

Glaucoma is characterized by progressive degeneration of retinal ganglion cells leading to optic neuropathy and visual field loss.

The major risk factor for glaucoma is elevated intra-ocular pressure (IOP) (Fig. 1). However, 30-40% of patients with glaucoma have normal IOP, leading to the classification of normal-tension glaucoma (NTG) (Fig. 1 C, E).^1,2 The prevalence of NTG varies between populations, with Asians having the highest prevalence (77- 92%), followed by Africans (57%), and Caucasians (30-39%).³ In a landmark study, the collaborative normal tension glaucoma study group (CNTGS) showed that a 30% reduction in IOP in NTG patients slowed the …

Giving More Than Vision: The Evolution And Impact Of Give Kids Sight Day, Leah Prischak, Bs

inSIGHT

Current literature strongly suggests that quality of life is diminished in children with visual impairments.¹ In many situations, visual impairment (VI) can be a serious barrier in obtaining the typical experiences and accomplishments of childhood. Evidence suggests an association between visual acuity, refractive error, and child academic performance.² VI is also associated with the prevalence of more intangible, psychological obstacles in areas such as independence and autonomy, concerns about the future, social relationships, participation, and acceptance.³

Retina In 10 Years—Exciting Developments, Amer Ahmed

inSIGHT

Significant advancements in the field of retina are expected over the next decade.

Wet AMD: Emerging Therapies
Wet age-related macular degeneration (AMD) is a chronic eye condition and a leading cause of vision loss in older adults. It occurs when abnormal blood vessels grow beneath the macula. These vessels are fragile and prone to leaking blood or fluid, which damages the retina and leads to rapid central vision loss.¹

Insight, Volume 5, Issue 1, 2025

inSIGHT

Contents

8 - Retina in 10 Years—Exciting Developments
By Amer Ahmed

12 - Giving More than Vision: The Evolution and Impact of Give Kids Sight Day
By Leah Prischak

15 - Vascular, Immunological, and Mechanical Factors in Normal Tension Glaucoma: A Multidimensional Approach to Pathogenesis
By Rachel Cain

22 - Recent Trends in the Ophthalmology Match
By Michael Pratt

25 - Idiopathic Intracranial Hypertension: A Comprehensive Review of Diagnosis and Management
By Sriya Sadhu

31 - Day in the Life of an Orbital and Oculoplastic Surgeon
By Alexis Duffy

35 - Idiopathic Intracranial Hypertension
By Tejal Patel

42 - Genetic …

Treatment Of Tics In Pediatric Patients With Neurodevelopmental Disorders, Faiza Ahmad

Research Colloquium

Background: The prevalence of chronic and transient tic disorders in children with neurodevelopmental delays is substantially higher than in the general pediatric population. Disorders including Tourette’s Syndrome, Chronic Persistent Motor Tic Disorder or Provisional Tic Disorder, can present challenges in treatment when comorbid neurodevelopmental disorders. Children with Autism Spectrum Disorder (ASD), Down’s Syndrome or other developmental delays may not be able to participate in first-line behavioral interventions like CBIT (Comprehensive Behavioral Intervention for Tics) therapy. Therefore, optimization of pharmacologic treatment is often necessary in this population, especially in the case of severe, refractory tics. Additionally, pharmacologic treatment can be …

Miconazole Induces Cell Cycle Arrest And Apoptosis In Prostate Cancer Cells Via A P53-Mediated Pathway: A Drug Repurposing Strategy, Eswara Naga Hanuma Kumar Ghali, Lindsey Shim, Rahul Tiwari, Rajasekhar Baru, Anupam Dhasmana, Ryan Chang, Sung Yun Jung, Vivek K. Kashyap, Neeraj Chauhan, Subhash Chauhan, Murali Yallapu

Research Colloquium

Aim: Repurposing of FDA-approved antifungal drugs to combat prostate cancer.

Background: Prostate cancer is one of the leading causes of cancer death among men in the United States, second only to non-melanoma skin cancer. The American Cancer Society estimates about 313,780 new cases and 35,770 deaths from prostate cancer in 2025. Despite various treatments such as radiation therapy (both external beam and internal), chemotherapy, hormone therapy, cryotherapy, biological therapy, and high-intensity focused ultrasound, men are monitored for side effects over many years. Therefore, new drugs and treatment strategies are urgently needed to address this challenge.

Methods: In this study, we …

Bridging Genetics And Pharmacology: Diazoxide Choline Xr (Vykat) In The Treatment Of Hyperphagia In Prader–Willi Syndrome, Elena Dike, Nazia Siddiqui, Astrid-Ines Foamkom, Bharathi Gadad

Research Colloquium

Prader–Willi Syndrome (PWS) is a rare genetic disorder caused by loss of paternal expression in the 15q11–q13 region, with the SNORD116/SNHG14 cluster most strongly linked to hyperphagia. This hyperphagia is a major cause of morbidity in PWS. Vykat, a recently approved FDA drug to treat hyperphagia in PWS acts by opening KATP channels in pancreatic β-cells, thereby reducing insulin secretion and indirectly improving satiety. This presentation aims to highlight the central hypothalamic dysfunction from genetic imprinting defects and the peripheral action of Vykat. While Vykat represents a significant advance, especially for individuals with severe hyperphagia, it does not address the …

Chromoblastomycosis Of The Diabetic Foot: A Diagnostic Challenge, Edwardo Abrego Ii, Laura Ackerman, Mario Trujillo-Acosta

Research Colloquium

Background: Chromoblastomycosis (CBM) is a rare transcutaneous fungal infection, estimated to affect roughly 1 in 8 million Americans annually. CBM is considered an occupational disease in tropical climates for farm workers exposed to contaminated soil/plants. This infection has an insidious onset and can be recurrent, yielding verrucous/nodular lesions that can be mistaken with polymicrobial bacterial infections in diabetic patients. If not promptly diagnosed and treated, CBM can lead to malignant transformation, which places an emphasis on a thorough history as this can influence proper workup.

Case Presentation: A 66-year-old Hispanic insulin-dependent type II diabetic male presented to the …

Hfd Feeding For Seven Months Abolishes Sting Disruption-Driven But Not Female Sex-Based Protection Against Hepatic Steatosis And Inflammation In Mice, Xinlei Guo, Honggui Li, Bilian Zhu, Xiaoxiao Wang, Qian Xu, Eduardo A. Aquino, Minji Koo, Qingsheng Li, James Cai, Shannon Glaser, Chaodong Wu

Research Colloquium

Stimulator of interferon genes (STING) is positively correlated with the degrees of liver inflammation in human metabolic dysfunction-associated steatotic liver disease (MASLD). In addition, STING disruption alleviates MASLD in mice fed a high-fat diet (HFD) for 3 months (3- m-HFD). Here we investigated the role of the duration of dietary feeding in regulating MASLD in mice and explored the involvement of STING in sex differences in MASLD. Both male and female STING-disrupted (STINGgt) and wild-type C57BL/6J mice were fed an HFD for 3 or 7 months (7-m-HFD). Additionally, female STINGgt mice upon ovariectomy (OVX) and 3-m-HFD were analyzed for MASLD. …

Delayed Diagnosis Of Systemic Lupus Erythematosus Presenting As Autoimmune Hemolytic Anemia: A Case For Heightened Clinical Suspicion, Diana Acosta Pozo, Luis Álvarez Pérez

Research Colloquium

Background: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease characterized by multisystem involvement, including hematologic manifestations. Autoimmune Hemolytic Anemia (AIHA), though an established feature, is relatively uncommon and may occur early or in isolation. When AIHA presents without overt systemic symptoms, the underlying autoimmune etiology may be overlooked, resulting in delays in diagnosis and treatment. Prompt recognition is essential to prevent unnecessary interventions and prolonged morbidity.

Case Presentation: A 39-year-old woman residing in Texas presented to the Rheumatology office with persistent synovitis and severe transfusion-dependent anemia, requiring red blood cell transfusions every 48 hours for over three months. She …

Generation Of Functional Hepatocytes From Human Induced Pluripotent Stem Cells, Daniela Gonzalez, Miriam Aceves, Lorena Guerra, Jose C. Granados, Felicia Juarez, Earl Novilla, Ana C. Leandro, Marcelo Leandro, Joanne E. Curran, John Blangero, Sarah Williams-Blangero, Satish Kumar

Research Colloquium

Background: One of the most common forms of chronic liver disease is nonalcoholic fatty liver disease (NAFLD). NAFLD is a condition of hepatic steatosis, excess fat accumulation in hepatocytes. It affects about 38% adults worldwide and about 50% adults in the Rio Grande Valley, and is a major risk factor for more serious nonalcoholic steatohepatitis (NASH), liver cirrhosis, and hepatocellular carcinoma (HCC). The risk for NAFLD is likely due to a complex interplay of genetic and environmental factors. Other metabolic diseases, such as obesity and type 2 diabetes, that have a high prevalence in the Valley, likely contribute to …

Educational Services And Language Congruency In Low-Income Children Who Are Deaf Of Hard-Of-Hearing, Courtney J. Austin, Dylan Chan, Jihyun Stephans

Research Colloquium

Background: Children who are deaf or hard-of-hearing (DHH) are required by United States law to have access to educational services through the Individuals with Disabilities in Education Act (IDEA). However, access to language-congruent providers, as well as supplemental services, varies considerably. Household income is associated with poorer hearing care access and outcomes in DHH children. We predict that access to supplemental, language-congruent DHH services is poorer in DHH children from lower-income homes.

Methods: This is a secondary, ad hoc exploratory study of DHH children aged 0-27 months enrolled in a randomized clinical trial (CT.gov: NCT04928209). Children were enrolled across all …

A Puzzling Case Of Visual Disturbances Leads To A Fatal Neurodegenerative Diagnosis, Courtney J. Austin, Aaron Carrillo, Jennifer Rojas Huen, Victoria Parada

Research Colloquium

Background: Creutzfeldt-Jakob disease (CJD) is a rare neurodegenerative disease in which early diagnosis is complicated by the presence of early non-specific and atypical presentations. Sporadic CJD (sCJD), the most common type of CJD, is caused by the spread of a disease-forming prion known as PrPSc. PrPSc multiplies and binds to the normal form of prion, or PrP, converting it to an abnormal, structurally altered disease form that spreads throughout the brain. sCJD can initially present with six different phenotypes: cognitive, affective, classic, visual (Heidenhain variant), atactic (Oppenheimer-Brownell variant), and indeterminate. The classic presentation of CJD includes rapidly progressive dementia with …

When The Hitts Keep Coming: A Case Of Takatsubo Cardiomyopathy Triggered By Delivering A New Diagnosis Of Multiple Myeloma, Corey Haines, Yareli Durazo, Tatiana Dacak, Bharat K. Peddinani, Nida Asif

Research Colloquium

Takotsubo cardiomyopathy (TCM), or stress-induced cardiomyopathy, is a transient condition often triggered by acute emotional or physical stress, typically presenting with chest pain, elevated cardiac biomarkers, and electrocardiographic changes mimicking acute coronary syndrome, but without obstructive coronary artery disease. We report the case of an 80-year-old male who developed TCM following the emotional stress of a new multiple myeloma diagnosis. His hospital course was complicated by acute heart failure, cardiogenic shock, and likely heparin-induced thrombocytopenia. Despite a critical ICU stay requiring mechanical ventilation, diuresis, and dialysis initiation, the patient’s cardiac function partially recovered. This case highlights the severe physiologic impact …

From Venom To Medicine: Harnessing Animal Toxins For Drug Discovery, Christine Vega, Ying Jia

Research Colloquium

Background: Drug development research has long focused on synthesizing novel therapeutics while overlooking isolation from naturally available sources such as animal venoms. Recently, the discovery of the therapeutic effects of highly bioavailable animal venom caused the field of venom research to soar in popularity. Animal venom serves as a natural, sophisticated tool optimized over millions of years by evolution with the ability to bind to ion channels such as nAChRs, non-specific ligand-gated ion channels distributed throughout the human nervous system. However, purifying individual venom toxins from crude venom is challenging due to its availability. Therefore, synthesizing large quantities of venom …

Material Hardship And Postpartum Depression: The Moderating Role Of Social Support Across Family Structures, Christine Pham, Chantal Uzoma, Monica Perez

Research Colloquium

Background: Economic hardship is a significant risk factor for postpartum depression (PPD), a condition with lasting impacts on maternal and child well-being (Agrawal et al., 2022). Although social support is theorized to buffer stress, little is known about whether its protective effects on PPD differ by family structure (Wang et al., 2023).

Objective: The objective of the current study is to examine whether higher social support moderates the association between material hardship and postpartum depression among new mothers and whether this relationship varies across marital status groups (married, cohabiting, single).

Methods: Data will be drawn from Wave 1 of the …

Optimizing Antibiotic Stewardship In Pneumonia: Evidence-Based Protocols For Enhanced Treatment And Resistance Reduction In A University-Affiliated Community Hospital, Carlos Luis Alejos, Jennifer Rojas Huen, Joan Beatrice Capellan, Ricardo Serna, Tejaswini Swamy, Jose Campo Maldonado

Research Colloquium

Introduction: National guidelines recommend early, targeted diagnostics such as respiratory viral panels, procalcitonin testing, Methicillin resistant staphylococcus aureus (MRSA) nasal swabs, and sputum cultures, for the effective management of pneumonia. However, our retrospective review at a university-affiliated community hospital revealed inconsistent application of these tools. These may contribute to excessive use of broad-spectrum antibiotics, higher costs, and increased antimicrobial resistance. The reason is that we aim to implement a standardized pneumonia order set in the electronic medical record (EMR) to improve diagnostic accuracy and antibiotic stewardship.

Methods: We conducted a retrospective chart review of adult inpatients admitted with community-acquired, hospital-acquired, …

The Price Of Copper: Unmasking Wilson’S Disease, Blake C. Martin, Stephen M. Garcia, Aun A. Bangash, Matthew Peynado, Jose Campo Maldonado

Research Colloquium

Background: This case highlights the diagnostic challenge of acute liver failure in a young adult initially presumed to have alcoholic hepatitis. Wilson disease, a rare but treatable cause of hepatic decompensation, must be considered, particularly in younger individuals with a suggestive biochemical profile and family history. The novelty of this case lies in the evolving diagnostic shift from alcohol-related liver disease to Wilson disease, underscoring the critical importance of comprehensive etiologic evaluation.

Case Presentation: A 28-year-old male with no known medical history presented with jaundice, abdominal pain, and systemic symptoms, including nausea, vomiting, and RUQ tenderness. He reported heavy alcohol …

The Link Between Pre-Existing Medical Conditions And Knee Meniscus Tear And Repair In Medically Underserved Community, Blake C. Martin, Manoj Peiris, Michael D. Sander

Research Colloquium

Introduction: Menisci function primarily in shock absorption and load transmission and can be torn, in isolation or concomitantly, via various activities. Our primary objective in this study was to analyze patients in the unique RGV community with various pre-existing medical conditions and determine if there was an association with the odds of having knee meniscus tear and repair surgery.

Methods: We conducted a retrospective chart review using the University of Texas Rio Grande Valley (UTRGV) UTHealth electronic database utilizing medical charts during the period January 1, 2018, to January 1, 2025. We collected and analyzed medical charts of individuals …

The Association Between Pre-Existing Medical Conditions And Trigger Finger Release In A Medically Underserved Region, Blake C. Martin, Manoj Peiris, Michael D. Sander

Research Colloquium

Background: Trigger finger is a relatively common condition that may affect daily activities. The Rio Grande Valley (RGV) is a health professional shortage area with a unique patient population. Our primary objective in this study was to analyze patients with various pre-existing medical conditions and determine if there was an association with the risk of trigger finger release surgery.

Methods: We conducted a retrospective chart review using the University of Texas Rio Grande Valley (UTRGV) UTHealth electronic database utilizing medical charts from January 1, 2018, to January 1, 2025. We collected and analyzed medical charts of patients who were diagnosed …

Chronic Conditions And Osteoporosis Risk: Insights From Penalized Logistic Modeling, Blake C. Martin, Juan Lopez Alvarenga

Research Colloquium

Background: The Rio Grande Valley (RGV) is a rural area with underserved, unique communities that may influence the health of the population. The primary objective of this study was to analyze factors associated with osteoporosis in individuals in the RGV to determine if the number of pre-existing medical conditions had an association with the frequency of osteoporosis. We hypothesized that individuals with more pre-existing medical conditions would be associated with an increased frequency of osteoporosis.

Methods: This study was a retrospective chart review from January 1, 2018, to January 1, 2025, using the University of Texas Rio Grande Valley (UTRGV) …

The South Texas Center Of Excellence In Cancer Research Core Facilities, Bianca Jimenez, Joel De Los Santos, Lindsey Shim, Iris Enriquez, Subhash Chauhan, Murali Yallapu

Research Colloquium

Background: The University of Texas Rio Grande Valley-School of Medicine (UTRGV-SOM) has founded the South Texas Centre of Excellence in Cancer Research to address disproportionate cancer related health issues in the Valley. UTRGV-SOM established an Integrated Cancer Research Core (ICRC, CPRIT/UT System), Drug Delivery and Nanomedicine Core (DDNC, CPRIT), and Research Capacity (RCMI) Facilities at the UTRGV campus to provide cutting-edge technologies to support cancer research investigators of the Rio Grande Valley. The ICRC will house technologies like Flow Cytometry, CyTOF, Image Stream Flow, Droplet Digital PCR, molecular and microPET/CT imaging. Our expertise and focus on this presentation will be …

Synthesis Of Various Flavonoids For Effective Anti-Immune Thrombocytopenia Agents, Benjamin Valdivia, Alyssa Aguilar, Victoria Herrera, Shizue Mito

Research Colloquium

Background: Immune thrombocytopenia (ITP) is a hematological disorder characterized by abnormally low platelet counts, often resulting in increased bleeding risk and impaired immune function. Current therapies may be costly, ineffective, or carry significant side effects, highlighting the need for safer, affordable alternatives. Carica papaya leaf extract has shown promise in increasing platelet counts, with flavonoids such as quercetin suggested as key bioactive constituents. However, unmodified plant compounds often suffer from limited potency or specificity. This research aims to synthesize structurally modified flavonoids derived from C. papaya to enhance their therapeutic activity for ITP. Our central hypothesis is that rational chemical …

The Intersection Of Obesity And Breast Cancer In South Texas: Clinical Implications And Regional Disparities, Aura M. C. Calderon, Ivan Mogollon, Luis Salcedo, Jose Loayza, Diane Nguyen

Research Colloquium

Introduction: Breast cancer continues to be the most frequently identified malignancy among females in both Texas and the broader United States. Although South Texas presents a marginally diminished incidence rate overall, the area persists in confronting significant disparities in terms of disease burden and health outcomes. These discrepancies are particularly pronounced among Hispanic women residing in the Rio Grande Valley (RGV), who encounter heightened probabilities of receiving diagnoses at advanced stages despite a lower general incidence rate. Structural inequities, such as restricted access to healthcare services, socioeconomic deprivation, and inadequate health literacy, interact with obesity-associated biological risk factors, thereby engendering …

Progressive Pulmonary Sarcoidosis In A Young Adult Mimicking Miliary Tuberculosis: A Case Report And Literature Review, Aura M. C. Calderon, Luis Salcedo, Ivan Mogollon, Francisco Arias, Juan Pablo Gomez

Research Colloquium

Introduction: Pulmonary sarcoidosis can pose considerable diagnostic challenges, particularly in young adults hailing from regions endemic to tuberculosis (TB), wherein radiographic manifestations may closely mimic those of miliary TB. This case underscores the necessity of sustaining an extensive differential diagnosis and accentuates the critical role of histological verification in the assessment of diffuse pulmonary micronodular infiltrates, especially in instances where the infectious workup yields negative results.

Case Report: A 26-year-old male from the Democratic Republic of Congo, with no significant medical history, presented with a 10–12 month history of chronic dry cough and exertional dyspnea. He denied fever, weight loss, …

Posterior Reversible Encephalopathy Syndrome (Pres) Secondary To B-Cell Acute Lymphoblastic Leukemia: A Case Report, Aura M. C. Calderon, Luis Salcedo, Ivan Mogollon, Jeyilis Carmona, Juan Pablo Gomez

Research Colloquium

Background: Posterior Reversible Encephalopathy Syndrome (PRES) represents a rare and potentially reversible neurotoxic disorder, distinguished by the presence of acute neurological manifestations and vasogenic edema, frequently detected through neuroimaging techniques. Although traditionally linked to hypertensive crises, renal insufficiency, and cytotoxic therapies, a growing body of evidence suggests that hematological malignancies, specifically acute lymphoblastic leukemia (ALL), should be regarded as an independent risk factor.

Case Presentation: A 73-year-old Hispanic female with a medical history significant for hypertension, type 2 diabetes mellitus, end-stage renal disease requiring hemodialysis, and Parkinson’s disease presented with a progressive decline in strength and altered cognitive status. Upon …

Cervical Cancer Disparities In Hispanic Women: A Multilevel Analysis Using Seer And Texas State Data, Aura M. C. Calderon, Ivan Mogollon, Shubhank Goyal, Jose Loayza, Everardo Cobos, Diane Nguyen

Research Colloquium

Background: Cervical carcinoma continues to exert a disproportionate burden on Hispanic women within the United States, notably in jurisdictions such as Texas, where individuals of Hispanic descent constitute more than 40% of the demographic populace. Notwithstanding progress in screening methodologies and preventive measures, considerable disparities persist in incidence rates, mortality figures, and survival outcomes when assessed through the lens of racial and ethnic stratifications.

Objective: To examine and visually communicate disparities in cervical cancer burden among Hispanic women through a combination of national survival data and Texas state-level incidence and mortality statistics.

Methods: Publicly accessible datasets were employed from the …

Case Report: Familial Hypomagnesemia In A Patient With History Of Hodgkin Lymphoma, Aura M. C. Calderon, Ivan Mogollon, Catherine Matos, Jose Loayza, Everardo Cobos

Research Colloquium

Introduction: Magnesium constitutes an essential electrolyte integral to the functioning of neuromuscular systems, the regulation of cardiovascular parameters, and the facilitation of metabolic processes. Chronic hypomagnesemia may precipitate significant complications, including the onset of arrhythmias and seizures. In cases where hypomagnesemia is refractory to supplementation and manifests in multiple family members, a hereditary tubulopathy, such as Gitelman syndrome (GS), warrants consideration. Gitelman syndrome is classified as an autosomal recessive disorder, resulting from mutations in the SLC12A3 gene, which impairs the thiazide-sensitive sodium-chloride cotransporter located in the distal convoluted tubule.

Case Presentation: A 39-year-old female with a history of classical Hodgkin …

Case Report: Clonidine Withdrawal-Induced Posterior Reversible Encephalopathy Syndrome (Pres), Aura M. C. Calderon, Francisco Arias, Ivan Mogollon, Luis Salcedo, Hector Arredondo

Research Colloquium

Introduction: Clonidine, an agonist of central α2-adrenergic and imidazoline receptors, possesses the capacity to elicit transient episodes of hypertension succeeded by hypotension and bradycardia. This particular case underscores a rare yet significant complication, Posterior Reversible Encephalopathy Syndrome (PRES), that can occur subsequent to the abrupt cessation of clonidine administration.

Case Presentation: An 18-year-old male with severe asthma and prior ICU admissions presented to the emergency department after two seizures. He had recently been treated for an asthma exacerbation complicated by hypertension, for which clonidine was initiated. He was discharged on clonidine and prednisone but discontinued clonidine the day before admission …

Think Beyond Migraine: A Case Of Transverse Venous Stenosis Masquerading As A Common Headache, Tejaswini Swamy, Aun A. Bangash, Chloe C. Harris, Victoria Parada

Research Colloquium

Introduction: Headache is a common complaint in clinical medicine, but when it is persistent, orthostatic in nature, and unresponsive to conservative therapy, it warrants evaluation for less common etiologies. This case highlights a compelling diagnostic journey involving intracranial hypertension secondary to transverse venous sinus stenosis (TVSS)—a condition that can be under-recognized, especially in patients without classic risk factors or overt imaging abnormalities. Here, a seemingly benign symptom masked a reversible cause of debilitating headaches, unmasked only through careful clinical suspicion and escalation to advanced neuroimaging. Most importantly, it reminds us that in patients with persistent symptoms, we must look beyond …