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Mural Thrombus in Abdominal Aorta Masquerading as an NSTEMI
No full textBackground: Mural thrombi in the abdominal aorta, although rare, represent a critical diagnostic and therapeutic challenge due to their potential for life-threatening complications such as embolism, ischemia, and end-organ failure. The prevalence of mural aortic thrombi reported in the literature ranges from 0.8% to 9.0%. However, as aortic thrombi often remain asymptomatic until a complication occurs, its true prevalence remains uncertain. There are no standardized guidelines for the treatment of aortic mural thrombi; however, treatment options include medical therapy with anticoagulation and surgical intervention, depending on the size of the thrombi and clinical presentation. Case Information: We present the case of a 72-year-old male who presented with the chief complaint of sudden onset, intermittent lower abdominal pain, moderate in intensity, non-radiating with no known aggravating or relieving factors. His medical history included essential hypertension, hyperlipidemia, and peripheral arterial disease. CT abdomen and pelvis with contrast identified a mural thrombus in the abdominal aorta at the origin of the superior mesenteric artery causing 50% stenosis, and atherosclerotic calcification without any evidence of aortic aneurysm. No evidence of bowel necrosis was noted on imaging. Laboratory workup ruled out inflammatory, infectious, or hypercoagulable states as underlying causes of intramural aortic thrombus. Lactic acid level (1.2mmmol/L), lipid profile, and coagulation profile were within normal limits. The patient denied any past trauma, familial aortopathies or vascular disease. Interestingly, the patient had elevated high-sensitivity troponin levels (HS-cTn 4693 ng/L) in the absence of chest pain or electrocardiographic evidence of acute ischemia, initially raising suspicion for non-ST-segment elevation myocardial infarction (NSTEMI). However, the etiology of the patient’s abdominal pain was eventually attributed to acute visceral ischemia, given that CT of the abdomen with contrast showed 50% stenosis of the superior mesenteric artery secondary to the mural thrombus. The patient was initiated on anticoagulation with unfractionated heparin, lipid-lowering drugs, antiplatelet therapy, and antihypertensive agents. Unfractionated heparin was later transitioned to a direct oral anticoagulant (DOAC). Coronary intervention was not done considering this patient did not have any anginal symptoms and possible risk of plaque rupture during cardiac catheterization. The multidisciplinary team decided against surgical intervention, and the patient responded appropriately to medical treatment with the resolution of abdominal pain. Conclusion: This case, initially presumed to be an NSTEMI due to elevated high-sensitivity troponin levels, highlights the importance of maintaining a high index of suspicion for mural thrombi as a potential cause of visceral bowel ischemia in patients presenting with non-specific abdominal pain. Early diagnosis through advanced imaging and prompt initiation of medical therapy likely prevented life-threatening complications such as embolism, ischemia, and end-organ failure
Empagliflozin facilitates endothelium-dependent vasodilation in a Dahl salt-sensitive model of heart failure
No full textPoster Highlight: College of Biomedical and Translational Science, RAD 2025 Award Winning Posters & Oral PresentationsPurpose: Heart failure with preserved ejection fraction (HFpEF) is a poorly understood clinical syndrome with few pharmacological treatments. In 2021, the EMPEROR-Preserved clinical trial demonstrated that empagliflozin, a sodium glucose cotransporter 2 (SGLT2) inhibitor used to treat diabetes, significantly reduced hospitalizations and cardiovascular deaths in HFpEF patients, regardless of their diabetic status. The mechanisms for these improvements remain unclear. Prior studies in the literature demonstrated that acute application of empagliflozin to vascular smooth muscles induces vasodilation. However, few studies have been conducted on empagliflozin’s effects on vascular function in HFpEF. We hypothesize that empagliflozin will improve vascular function (increased vasodilation, decreased vasoconstriction) in a rat model of HFpEF. Additionally, we hypothesize that empagliflozin-induced improvements to vascular functions will be greater in female than male rats. Methods: Dahl salt-sensitive rats were used to model HFpEF. When fed a high-salt diet over several weeks, this rat model will develop hypertension, kidney disease, and other clinical signs and symptoms similar to HFpEF. Rats were divided into three groups based on diet: a control group receiving normal chow (0.3% NaCl), a diseased group receiving specialized high salt chow (HS, 8% NaCl), and a treatment group receiving both high salt and empagliflozin (Empa, 10 mg/kg/day, via drinking water). Rats were humanely euthanized after 8 weeks of diet and femoral arteries were collected. Vascular function was then assessed with isometric tension experiments using wire myography. All vessels were normalized to produce maximal active tension. Dose-response curves were recorded by applying increasing doses of phenylephrine (PE, vasoconstrictor) and acetylcholine (ACh, vasodilator) to the vessels. Results: A repeated measures 2-way ANOVA was performed comparing the effects of ACh/PE dosage and treatment conditions on vasodilation/vasoconstriction in all groups, regardless of sex. The results for treatment conditions indicate that PE-induced vasoconstriction was not significantly changed in the Empa-treated group compared to the diseased or control groups (F (2, 18) = 1.63, p = 0.22). Likewise, the effect of treatment conditions on ACh-dependent vasodilation was not significantly different between the three groups (F (2, 23) = 0.39, p = 0.68). Sex differences were identified, however, in ACh dose-response curves for the treatment group. At doses of 0.1 µM, 1.0 µM, and 10.0 µM ACh, male rats on HS+Empa had greater endothelium-dependent relaxation compared to females (0.1 µM ACh, male 76.64 +/- 9.24% vs. female 22.02 +/- 7.22%, p < 0.01; 1.0 µM ACh, male 85.43 +/- 6.56% vs. female 36.10 +/- 8.04%, p < 0.01; 10.0 µM ACh, male 73.29 +/- 10.19% vs. female 37.50 +/- 7.45%, p < 0.05). Conclusion: The data suggest that empagliflozin may have a sex dependent effect on vascular function. Males with HFpEF might experience a greater improvement in vascular function (via increased endothelium-dependent vasodilation) than females with HFpEF. Future studies should investigate the mechanisms by which empagliflozin facilitates this greater improvement in males with HFpEF. Additionally, more research is needed in different models of HFpEF to determine if empagliflozin contributes to improvements in vascular functions in other ways
Leveraging Machine Learning and Feature Importance Techniques in Neuroimaging to Identify Critical Brain Regions Strongly Predictive of Alzheimer's Disease
No full textIntroduction: Machine learning (ML) is a branch of artificial intelligence (AI) that utilizes data and algorithms to generate predictions across various scientific disciplines. Support Vector Machine (SVM) is an ML technique that integrates decision trees and employs SHapley Additive exPlanations (SHAP) values and feature importance analysis to interpret results. These approaches are particularly useful for analyzing neuroimaging data in individuals with Alzheimer’s disease (AD). Key brain regions affected by AD include the cortical region, hippocampus, entorhinal cortex, and medial temporal lobe. MRI and diffusion tensor imaging (DTI) can quantify degeneration in these areas, allowing comparisons with cognitively normal elderly individuals. This study aims to analyze neuroimaging data from individuals with AD, mild cognitive impairment (MCI), and cognitively unimpaired adults across diverse racial and ethnic backgrounds. Using SVM, we identify brain regions that are predictive of an AD diagnosis. Methods: We utilized neuroimaging and clinical data from a multi-ethnic cohort of 2,950 participants, including individuals classified as cognitively normal (NC), MCI, or AD. Participants underwent neurocognitive testing, imaging studies, functional assessments, and laboratory testing. The cohort consisted of individuals who self-identified as Hispanic, non-Hispanic White, and non-Hispanic Black, with 1,099 males and 1,851 females. Independent variables included neuroimaging data from DTI and Tau PET scans using the PI2620 tracer, alongside MRI-derived brain region thickness and volume. The primary dependent variable was cognitive status, classified as either NC or cognitively impaired (CI), with CI encompassing both MCI and AD. Neuroimaging data were processed using SVM to evaluate feature importance across brain regions. DTI metrics, including radial diffusivity, mean diffusivity, axial diffusivity, and fractional anisotropy, were analyzed to assess white matter integrity. Results: Feature importance analysis demonstrated that Tau PET scans of the posterior cingulate and lateral parietal regions were the strongest predictors of CI in a combined MCI/AD model across all racial and ethnic groups. DTI, particularly axial diffusivity (AD), was the second most predictive scan type for CI diagnosis. Axial diffusivity identified the splenium and body of the corpus callosum as key predictive regions. SHAP values confirmed the posterior cingulate and lateral parietal regions as the most significant predictors. Discussion: Findings indicate that increased Tau uptake in the posterior cingulate and lateral parietal regions, along with reduced white matter water diffusion in the corpus callosum, were the most significant neurodegenerative changes observed across Black, Hispanic, and White participants. While axial diffusivity has traditionally been underutilized in neuroimaging analysis, our results suggest it may be a valuable predictive tool for AD diagnosis. SVM-based machine learning models show promise in identifying neuroimaging biomarkers for AD, though their accuracy remains dependent on the quality and diversity of available data
Single Quadrupole LC-MS Method for Quantification of Amphotericin B in Mouse Plasma
No full textPurpose: Amphotericin B (AmB), a parenterally administered polyene antifungal agent, is a critically important compound in the treatment of severe and systemic fungal infections. To date, bioanalytical quantification methods for AmB in plasma and other biological matrices have relied either solely on high-performance liquid chromatography (HPLC) or have required the use of expensive triple-quadrupole mass spectrometry. These methods have been limited largely by sensitivity or cost, respectively. The purpose of this research was to develop and validate a single-quadrupole liquid chromatography-mass spectrometry (LC-MS) method that could improve upon the sensitivity of HPLC methods while also being more accessible and affordable than triple quadrupole methods. Methods: We utilized a single-quadrupole LC-MS to measure plasma samples. A protein precipitation method was optimized to extract AmB from the plasma. Sorafenib was used as an internal standard for quantitative measurement. A gradient elution method was optimized to separate AmB and sorafenib. The mobile phase consisted of methanol with 0.03% formic acid, acetonitrile with 0.03% formic acid, and MilliQ water with 0.03% formic acid in proportions programmed along the method gradient. The gradient eluted from 90% water, 5% methanol and 5% acetonitrile to 34% water, 20% methanol and 46% acetonitrile and then back over the run time of 10 minutes. The injection volume was 30 mL. MS parameters were also optimized to achieve the greatest sensitivity. The LC-MS method was fully validated according to the FDA’s bioanalytical guidance. Three quality of control (QC) samples at 62.5, 250 and 500 ng/mL were used for validation. Results: We found that a 4:1 ratio of 0.03% formic acid in methanol to plasma spiked with AmB and internal standard generated optimal results. The extraction efficiency was higher than 75% for the tested QC samples. The limit of quantification was 31 ng/mL with a limit of detection of 15.6 ng/mL. The range of the linearity was from 31 ng/mL - 1000 ng/mL with a determination coefficient (R²) of 0.9994. Plasma extraction samples were stable for 4 hours on the benchtop, 8 hours in the HPLC autosampler, and 24 hours at -80° C. Inter- and intra-day precision and accuracy were validated for each concentration at n=6 on three separate days, never exceeding ±15% nominal concentration or ≥15% coefficient of variation. AmB and sorafenib peaks were well-separated and demonstrated no carryover at the retention times of 2.9 minutes (AmB) and 4.7 minutes (sorafenib) respectively. Conclusions: An LC-MS method coupled with a single-quadrupole MS was successfully developed and validated. The method can be performed using inexpensive and readily available materials, is easy to replicate, and has a fast turnaround time. Implementing a simple, single-step protein precipitation for sample preparation, this novel method bridges the gap between HPLC- and triple quadrupole LC-MS/MS-driven approaches, exhibiting cost-effectiveness while maintaining practical and analytical robustness
ctDNA Monitoring in Neuroblastoma Highlights Disease Dynamics and Precision Oncology Challenges
No full textPoster Highlight: Texas College of Osteopathic Medicine - Research, RAD 2025 Award Winning Posters & Oral PresentationsBackground: Neuroblastoma poses significant challenges in pediatric oncology, particularly in high-risk cases characterized by genetic complexity and frequent relapse. Circulating tumor DNA (ctDNA) has emerged as a promising non-invasive biomarker for monitoring disease progression and treatment response. Objectives: This study aimed to evaluate the utility of ctDNA as a biomarker for treatment response and relapse in high-risk neuroblastoma (HR-NBL). It assessed correlations between ctDNA metrics, such as variant allele frequency (VAF) and tumor fraction (TF), and clinical outcomes. Additionally, ctDNA findings were compared with imaging results (¹²³I-MIBG and other modalities) and tissue sequencing at relapse to identify genomic alterations. The study also explored the limitations of ctDNA monitoring in detecting tumor heterogeneity and its concordance with other diagnostic methods. Design/Method: This retrospective study analyzed 13 neuroblastoma patients with multiple ctDNA samples, collecting clinical and molecular data via chart review. ctDNA, assessed using FoundationACT™ and FoundationOne® Liquid CDx, was correlated with imaging to assess its utility as a biomarker for treatment response and relapse. ctDNA findings were compared with tissue sequencing results at relapse, and the ability to detect actionable genomic alterations and track disease dynamics was evaluated. Statistical analyses examined relationships between ctDNA levels, imaging, treatment outcomes, and time to relapse (p < 0.05). Results: Significant differences in VAF (χ² = 9.76, p = 0.045) and TF (χ² (3, n = 13) = 8.9, p = 0.03) were observed across response groups. Progressive disease correlated with rising VAF and TF, while stable and partial responses were associated with decreasing metrics. ctDNA findings often tracked with clinical outcomes, successfully predicting relapse in some cases. However, discordance between ctDNA and tissue sequencing at relapse was observed in four patients, with ctDNA failing to detect key alterations such as HRAS K117N, and ERBB2 amplification. Additionally, ctDNA identified a rare germline SMARCA4 variant classified as a Variant of Uncertain Significance (VUS), underscoring its potential to reveal clinically relevant genetic alterations. Conclusion: While ctDNA shows promise as a non-invasive tool for disease monitoring and treatment response in HR-NBL, its clinical utility is limited in a subset of patients. These findings highlight the need for larger, prospective studies, pediatric-specific assays, and integration of ctDNA with tissue sequencing to optimize its application. Enhanced sensitivity and longitudinal studies are essential to establish ctDNA as a reliable biomarker in neuroblastoma management
Chronic Adenoiditis Complicated by Staphylococcus pseudintermedius: A Case Report Highlighting Silver Nitrate Therapy for Biofilm-Associated Infections
No full textBackground: Adult chronic adenoiditis is a rare condition often characterized by the sensation of upper airway obstruction, persistent nasal congestion, and sore throat. This condition is frequently a result of polymicrobial infections and can be associated with biofilm formation resulting in infection persistence and resistance to treatment. Although adenoidectomy is often the pursued treatment, biofilm-related infections have been known to persist, requiring other therapeutic approaches to treat this condition. This case report highlights the clinical course of a patient with chronic adenoiditis refractory to mainstay treatments complicated by biofilm-producing Staphylococcus pseudintermedius. The use of silver nitrate (AgNO3) as a therapy is explored. Case Presentation: A 32-year-old female presented to the clinic with a foreign body sensation in the posterior nasopharynx and persistent post-nasal drip. The patient’s surgical history included septoplasty and inferior turbinate reduction, both of which were completed in an attempt to provide symptomatic relief. After a diagnostic workup, adenoidectomy and systematic and topical antibiotics were recommended. After the completion of these treatments, her symptoms persisted. Cultures following adenoidectomy and antibiotic rinses revealed the presence of S. pseudintermedius, prompting consideration of biofilm-targeted interventions. AgNO3, is an antibacterial and cauterization agent commonly used in otolaryngologic and dental procedures. There have been reported cases of its use in topically treating infections resulting from biofilm-producing pathogens. In this case, topical application of AgNO3 was performed to the adenoid bed under endoscopic guidance, complemented by systemic and topical antibiotic therapy. After treatment, therapy was discontinued and serial silver nitrate applications were not pursued due to severe post-procedural pain and a lack of appreciable clinical improvement. Conclusion: Chronic biofilm-associated infections of adult adenoid tissue remain a significant therapeutic challenge. This case illustrates the limitations of silver nitrate therapy in the treatment of bio-film-associated chronic adenoiditis and points to the need for further research into targeted strategies for improved patient outcomes in refractory cases
Does getting a preoperative echocardiogram change operative management for hip fractures? A literature review
No full textBackground: Hip fractures occur in 1 of 3 women and 1 of 12 men, with approximately 86% of hip fractures occurring in individuals greater than 65 years of age. In addition to a significant financial burden and loss of independence, hip fractures are associated with significant peri-operative complications, morbidity, and mortality [Schnell]. In the geriatric community, some of the most significant peri-operative complications are adverse cardiac events which can be assessed via cardiac risk scores, stress tests, and preoperative echocardiogram (POE). However, POEs can delay surgery leading to increased morbidity and mortality especially in the setting of a hip fracture. Our purpose was to determine the indications and risks of conducting a POE with regards to if the benefits outweigh post-op complications. Methods/Results: A literature search was conducted excluding articles prior to 2017 while including those that focused specifically on POEs in the workup for hip fracture surgery.There still lays a lack of consensus regarding the utility of TTE as a way to measure postoperative risk. Many articles continue to argue that POEs can decrease postoperative cardiac complications while others state that there is no benefit with POEs with an increase in harm from surgical delay. As part of the clinical practice guidelines (CPGs) and a number of extensive studies, the field of orthopedics agrees that increased time to OR (TTO) is associated with more significant post-operative complications and a greater length of stay (LOS) in patients with hip fractures. Additionally, POEs can significantly increase medical costs without a significant change in medical management. Discussion/Conclusion: This review summarizes current recommendations for incorporation of POEs in workup for hip fracture management. TTEs can significantly influence TTO and increase post-operative complications while also providing the operative care team with vital information that can significantly impact patient mortality. However, in-place of a full TTE, it may be a better utilization of medical resources in high-risk patients to order a focused TTE that looks at LVEDD, LVEF, and the presence of AS to balance the benefits of a TTE while avoiding surgical delay
An Unusual Case of Indolent Systemic Mastocytosis: Diagnostic Insights in the Absence of Classic Systemic Symptoms
No full textIntroduction: Mastocytosis is a disorder characterized by an abnormal clonal accumulation and subsequent activation of mast cells within one or more organs. It is generally classified as either cutaneous, with or without systemic involvement, or systemic without cutaneous disease based on major and minor criterion. Indolent systemic mastocytosis (ISM) is a subclass of systemic mastocytosis with generally good prognosis. While the etiology of ISM is not completely understood, those who are affected typically have the KIT D816V mast cell receptor mutation. Given that ISM is mast cell mediated, patients predominantly present with a wide range of symptoms related to mast cell degranulation, including flushing, anaphylaxis, gastrointestinal disturbances, and bone pain that can cause disruption to quality of life. Case Presentation: A 61-year-old Caucasian female presented for the evaluation of a pruritic rash on her trunk and extremities. The rash had persisted for 43 years and she described ongoing pruritus significantly impacting daily activities, particularly bathing with warm water, which made the itching unbearable. She also experienced episodes of brain fog predating menopause There was no history of angioedema, asthma, wheezing, abdominal symptoms, or bone pain. Her daughter was also affected by a similar condition. Dermatologic examination revealed innumerable reddish-brown macules and patches on the trunk and extremities, most concentrated on the lower legs. These lesions formed wheals when stroked firmly. A skin biopsy revealed abnormally increased mast cell concentration in the dermis. Laboratory studies showed elevated serum tryptase, low total protein, low globulin, and high albumin/globulin ratio. A bone marrow biopsy revealed multifocal dense mast cell infiltrates with absent iron stores. Genetic testing was negative for mutations in KIT D816V. The patient met criteria for ISM and her symptoms were managed by varying degrees with Omalizumab, Montelukast, Cetirizine, and topical Clobetasol. She continues to have flares to this date. Learning Points: Cutaneous mastocytosis can reliably be diagnosed clinically using Darier’s sign, in which rubbing a lesion induces wheal formation due to mast cell degranulation. Additionally, while virtually all ISM cases are linked to the KIT D816V mutation, this patient’s genetic testing was negative for the mutation, suggesting an alternative disease mechanism. Recent advancements in therapy offer new treatment options, providing hope for patients who, like this one, have endured over 40 years of limited therapeutic success. ISM, though carrying a favorable prognosis, can significantly impact quality of life through persistent symptoms
Addressing the Impact of Systematic, Opt-Out Syphilis Testing in the Emergency Department on Rates of Congenital Syphilis
No full textPurpose: Syphilis is a sexually transmitted infection from the spirochete bacterium Treponema pallidum that is notorious for being challenging to diagnose due to its variable and sometimes asymptomatic presentation. Congenital syphilis (CS) is an infection of syphilis that is passed from mother to baby via transplacental transmission during pregnancy. CS can lead to miscarriage, stillbirth, prematurity, and fetal death. Babies born with CS can have systemic manifestations, including skeletal, neurological, and hematological abnormalities. The treatment for syphilis during pregnancy is intramuscular penicillin G. Despite that syphilis is treatable and CS is preventable, the rate of CS has increased every year in the U.S. since 2013. Rising rates is attributable to inadequate testing and treatment for pregnant women, which indicates missed opportunities for prevention of CS. Additionally, there is currently a national shortage of penicillin G, further emphasizing the importance of screening, treatment, and prevention of CS. As utilization of primary care declines and emergency departments become more important as safety nets, the emergency department is in a unique position to make an impact on increasing screening rates for syphilis in pregnant women. The purpose of this study is to explore current literature to evaluate impact of universal screening for syphilis in the emergency room on the rate of congenital syphilis. Methods: A literature review was conducted using the following electronic databases: PubMed, Embase, Medline Complete, and ProQuest Central. Keywords include screening, testing, diagnosis, congenital syphilis, treponema, emergency room, prevention. Articles were limited to English and dated 2014 or later. Studies selected include quantitative, comparative, and systematic reviews. Results: Fifteen studies have shown that implementation of universal screening for syphilis in the emergency department could decrease the rates of congenital syphilis. Successful screening strategies were identified as: screening all women of childbearing age, screening all pregnant women, co-testing with other STIs, and screening based on robust, inclusive criteria. Unsuccessful strategies were identified as: screening based on CDC’s risk factors alone, screening based on clinical presentation, screening at prenatal visits or sexual health clinics alone. Increased testing resulted in improved diagnosis and treatment of syphilis, regardless of clinical presentation. One study uncovered rates of syphilis double the national average, and another study averted nine cases of CS through universal screening. Conclusions: Syphilis is often asymptomatic, leading to missed diagnoses. Additionally, only half of pregnant women are positive for risk factors established by the CDC. As less patients engage in primary care, the emergency department has a unique position in prevention of CS. The results from recent studies support that implementation of universal syphilis screening can increase the diagnosis and treatment of syphilis, and therefore prevent CS
Endothelin-1 mediated changes in mitophagy in retinal ganglion cells and optic nerves of mice.
No full textEndothelin-1 mediated changes in mitophagy in retinal ganglion cells and optic nerves of mice. Purpose: Many studies have found endothelin-1 (ET-1) to be a potent vasoactive peptide responsible for neurodegeneration of retinal ganglion cells (RGCs) and their axons in rodent models of glaucoma. Although ET-1 is a potent vasoactive peptide, it has been demonstrated to cause RGC death through vascular independent mechanisms, including alterations in expression of several mitochondrial genes, leading to mitochondrial dysfunction and cell death. In this study we wanted to determine the effect of ET-1 administration on RGC mitophagy at 24 hrs and 72 hrs post intravitreal (IVT) injection in mice. Methods: MitoQC mice, containing a genetic dual fluorophore mitophagy flux indicator, were used to determine mitophagy. Mitophagy is defined here as the total area of mitolysosomes within the tissue (for the optic nerves) and as a percentage of ganglion cell area that comprises mitolysosomes (for the retina). The ratio of red fluorescence to green fluorescence in RGCs is used to identify mitolysosomes. The mice received either IVT ET-1 injection or IVT vehicle (VEH) injection. The eyes were fixed and sectioned for immunohistochemistry to evaluate mitophagy of RGC at either 24 hrs or 72 hrs post injection. The retinas were stained with antibodies against RBPMS to identify retinal ganglion cells, and the images were analyzed using a previously established semi-automatic method. Mitophagy was quantified and analyzed in both young and old mice, as well as in both the retina and the optic nerve. Results: When observing mitolysosomes in the optic nerve, ET-1-injected mice exhibited a higher level of mitophagy at 24 hours compared to vehicle-injected mice at the same time point, although this difference was not statistically significant. On the other hand, there was a significant reduction in mitophagy in optic nerve samples obtained 72 hours after ET-1 injection when compared to samples obtained 24 hours after ET-1 injection (p=0.0313, Fisher’s LSD). In contrast, when examining retina samples in mice eyes injected with ET-1, there appeared to be an increasing trend in mitophagy at 72 hours compared to 24 hours in the RGCs from ET-1 injected mice eyes, although this difference did not reach statistical significance due to the limited sample size. There was no appreciable change in mitophagy in the vehicle injected mice eyes over time (24 hrs versus 72hrs). Conclusion: Analysis of mitochondrial morphology revealed that ET-1 injection had a significant effect on RGC mitophagy in the optic nerve post-injection. Interestingly we found mitophagy to be increased 24 hrs post injection in the optic nerves; however, mitophagy showed an increasing trend at 72hrs post injection in the retina samples. If significance is detected in the retina samples, it is possible that distinct mechanisms are responsible for mitophagy in ET-1-injected mice. Ongoing, studies with increased sample size will facilitate a comprehensive understanding of the effects of ET-1 on mitophagy in the retina and optic nerve