Allergic Fungal Rhinosinusitis in a 12-Year-Old Male Resulting in the Remodeling of Cribriform Plate With Protrusion Into the Anterior Cranial Fossa: A Case Report.

Allergic fungal rhinosinusitis (AFRS) in the pediatric population is a rare pathologic entity, and it is characterized by a type I hypersensitivity reaction to sinus fungi promoting the development of eosinophilic inflammation and thickened mucin. In the United States, a higher prevalence of AFRS is found among younger populations, African Americans, in counties characterized by elevated poverty rates, and patients without insurance or those reliant on Medicaid. Early clinical suspicion is essential for the timely diagnosis of this condition and to prevent the dissemination of the disease, thereby achieving a favorable prognosis. We report a case of a 12-year-old African American male who presented with the gradual onset of asymptomatic proptosis and seasonal allergy symptoms resulting in unilateral relative afferent pupillary defect and was ultimately diagnosed with AFRS.

Endothelial MRs Mediate Western Diet-Induced Lipid Disorders and Skeletal Muscle Insulin Resistance in Females.

Consumption of a Western diet (WD) consisting of excess fat and carbohydrates activates the renin-angiotensin-aldosterone system, which has emerged as an important risk factor for systemic and tissue insulin resistance. We recently discovered that activated mineralocorticoid receptors (MRs) in diet-induced obesity induce CD36 expression, increase ectopic lipid accumulation, and result in systemic and tissue insulin resistance. Here, we have further investigated whether endothelial cell (EC)-specific MR (ECMR) activation participates in WD-induced ectopic skeletal muscle lipid accumulation, insulin resistance, and dysfunction. Six-week-old female ECMR knockout (ECMR-/-) and wild-type (ECMR+/+) mice were fed either a WD or a chow diet for 16 weeks. ECMR-/- mice were found to have decreased WD-induced in vivo glucose intolerance and insulin resistance at 16 weeks. Improved insulin sensitivity was accompanied by increased glucose transporter type 4 expression in conjunction with improved soleus insulin metabolic signaling in phosphoinositide 3-kinases/protein kinase B and endothelial nitric oxide synthase activation. Additionally, ECMR-/- also blunted WD-induced increases in CD36 expression and associated elevations in soleus free fatty acid, total intramyocellular lipid content, oxidative stress, and soleus fibrosis. Moreover, in vitro and in vivo activation of ECMR increased EC-derived exosomal CD36 that was further taken up by skeletal muscle cells, leading to increased skeletal muscle CD36 levels. These findings indicate that in the context of an obesogenic WD, enhanced ECMR signaling increases EC-derived exosomal CD36 resulting in increased uptake and elevated concentrations of CD36 in skeletal muscle cells, contributing to increased lipid metabolic disorders and soleus insulin resistance.

Effect of Selective Laser Trabeculoplasty on the Fellow Eye.

Aim: Determine if selective laser trabeculoplasty (SLT) affects the fellow eye's intraocular pressure (IOP). Materials and methods: A retrospective review of 76 pairs of eyes from 76 adult glaucoma patients who underwent SLT in one eye with at least 2 months between treatments were evaluated for IOP and medication reduction in the untreated fellow eye. Success was defined as ≥20% IOP reduction or ≥1 medication reduction without any additional IOP lowering procedures or medication. The primary outcome measures were success, IOP, and medication reduction in the untreated fellow eye at 6 months. Results: At 6 months after SLT treatment, 48.7% (38/76) treated eyes and 36.8% (28/76) untreated fellow eyes met success criteria. IOP reduction in the treated eye was 2.6 ± 5.8 (14.1%; p < 0.002) and 0.8 ± 4.3 (5.1%, p = 0.122) in the fellow eye. The fellow eye was significantly more likely to meet success criteria if the treated eye was successful [odds ratio (OR): 6.00, 95% confidence interval (CI) (2.11-17.06), p < 0.002]. Conclusion: After a unilateral treatment with SLT, over one-third of the fellow eyes experienced either ≥20% IOP reduction or medication reduction. Additionally, fellow eyes were six times as likely to meet success criteria if this was observed in the treated eye. These findings may support the proposed biochemical mechanism for the therapeutic action of SLT. Clinical significance: The implication for clinicians is that SLT treatment in one eye may allow the fellow eye to benefit and provide a prediction on the fellow eye's response without subjecting both eyes to the rare but present complications of SLT. How to cite this article: Hirabayashi M, Mellencamp E, Duong S, et al. Effect of Selective Laser Trabeculoplasty on the Fellow Eye. J Curr Glaucoma Pract 2023;17(4):175-177.