Habib, A. E., A. A. Abdel-Kader, I. M. Eissa, and A. Awadein, "Adherence to Intravitreal Anti-Vascular Endothelial Growth Factor (Anti-VEGF) Drugs in Diabetic Macular Edema in an Egyptian Population: A Health Belief Model.", Current eye research, vol. 44, issue 3, pp. 303-310, 2019. Abstract

PURPOSE: To determine the factors that influence the adherence to follow-up and injections in patients with diabetic macular edema (DME) utilizing a health belief model (HBM) as a theoretical framework, and using demographic variables and knowledge about DME as factors that influence individual perceptions.

MATERIAL AND METHODS: A structured questionnaire was developed utilizing the six domains of HBM and using knowledge and other demographics as modifying variables. The questionnaire was checked for validity and reliability, and then used to collect data from patients with DME who were candidates for intravitreal injections according to pro-re-nata regimen, and completed one year after the first injection. Univariate and multivariable analysis was performed to identify factors associated with poor adherence.

RESULTS: Of all 343 included patients (168 women and 175 men; mean [SD] age, 58[10] years, 71 (20.7 %) patients dropped visits and/or injections during the first year of treatment. Mean number of dropped injections was 1.32 ± 0.65 (range 1-5 injections). Factors associated with non-adherence were unilaterality of the injection (p < 0.001), absence of funding (p = 0.002), higher perceived barriers (p = 0.011), lower perceived benefits (p = 0.015), lower self-efficacy (p = 0.023), and lower perceived susceptibility (p = 0.029). In multivariable logistic regression model, the final goodness of fit with the data of the model was high (χ/df = 1.81, p < 0.001).

CONCLUSIONS: Funding and psychological burden are the main controllable factors for compliance to anti-VEGF therapy in DME. Identifying reasons for non-adherence could contribute to a better outcome.

Eissa, I. M., "The tap clap and snap interactive challenge: An auditory feedback semi-game to improve classroom engagement.", Medical education, vol. 54, issue 11, pp. 1044-1045, 2020.
El Gendy, H. A., N. M. Khalil, I. M. Eissa, and S. M. A. Shousha, "The Effect of Strabismus Muscle Surgery on Corneal Biomechanics.", Journal of ophthalmology, vol. 2018, pp. 8072140, 2018. Abstract

Purpose: Studying the early effect of different extraocular muscle (EOM) surgeries on corneal biomechanics.

Subjects and methods: This is a prospective, nonrandomized, interventional study, in which 42 eyes of 29 candidates for EOM surgery for strabismus correction at Cairo university hospitals, aged 14-37 years, were recruited. All participants had measuring of the visual acuity, refraction (spherical equivalent (SE)), assessment of the EOM motility and muscle balance, sensory evaluation, fundus examination, and assessing the ocular biomechanics using the Ocular response analyzer (ORA, Reichert, INC., Depew, NY) noting the corneal hysteresis (CH) and corneal resistance factor (CRF) preoperatively. Same patients were reassessed using ORA 4 weeks postoperatively following a different standard EOM surgery (recti weakening/strengthening and inferior oblique weakening either (graded recession) according to the surgical indication, and ∆CH and ∆CRF were calculated, each is the preoperative - the postoperative value.

Results: ∆CH and ∆CRF = -0.78 ± 1.56 and -0.72 ± 2.15, respectively, and a highly significant difference was found between each of the pre- and postoperative CH and CRF ( < 0.001). 18 eyes had single EOM surgery, while 24 had multiple (2 or 3) EOM surgery; ∆CH in the single group = -1.28 ± 1.5, and ∆CH in the multiple group = 0.4 ± 1.49 (=0.07). 23 eyes had EOM weakening surgery, while 18 had combined weakening and strengthening EOM surgery: ∆CH in the weakening group = -1.24 ± 1.77 and ∆CH in combined group = -0.26 ± 1.07 (=0.04). A nonsignificant difference was found for ∆CRF (=0.53).

Conclusion: A different EOM surgery has an early tendency for increase of the postoperative CH specially for muscle weakening procedures (recti recession/inferior oblique muscle weakening).

Hussein, M. A., I. M. Eissa, and A. A. Dahab, "Vision-Threatening Behcet's Disease: Severity of Ocular Involvement Predictors.", Journal of ophthalmology, vol. 2018, issue 2018, pp. 9518065 / 6 pages, 2018. Abstract
application/pdf iconpredictors_for_severity_behcet_____final_1.pdf

Purpose: To examine and spot systemic findings commonly associated with a serious form of ocular Behcet's disease. This could potentially help ophthalmologists categorize their patients based on future risk and plan treatment accordingly.

Subjects and Methods: The data of 249 patients with Behcet's disease were examined thoroughly. Correlations between systemic and ocular findings were recorded. Patients were further subgrouped by the authors as having a vision-threatening form of the disease or not. Regression analysis was done to spot predictors for a vision-threatening form of the disease.

Results: The presence of systemic vasculitis and oral and genital ulcers in a patient with Behcet's disease was found to be associated with a milder form of ocular affection or none at all and vice versa. Certain correlations between findings were also found.

Conclusion: Certain findings in Behcet's disease may act as predictors for the severity of ocular affection. Directing our attention to these factors by the internist and ophthalmologist can help plan the frequency of follow-up as well as the aggressiveness of treatment in patients with Behcet's disease.

Hussein, M. A., I. M. Eissa, and A. A. Dahab, "Vision-Threatening Behcet's Disease: Severity of Ocular Involvement Predictors.", Journal of ophthalmology, vol. 2018, issue 2018, pp. 9518065 / 6 pages, 2018. Abstract

Purpose: To examine and spot systemic findings commonly associated with a serious form of ocular Behcet's disease. This could potentially help ophthalmologists categorize their patients based on future risk and plan treatment accordingly.

Subjects and Methods: The data of 249 patients with Behcet's disease were examined thoroughly. Correlations between systemic and ocular findings were recorded. Patients were further subgrouped by the authors as having a vision-threatening form of the disease or not. Regression analysis was done to spot predictors for a vision-threatening form of the disease.

Results: The presence of systemic vasculitis and oral and genital ulcers in a patient with Behcet's disease was found to be associated with a milder form of ocular affection or none at all and vice versa. Certain correlations between findings were also found.

Conclusion: Certain findings in Behcet's disease may act as predictors for the severity of ocular affection. Directing our attention to these factors by the internist and ophthalmologist can help plan the frequency of follow-up as well as the aggressiveness of treatment in patients with Behcet's disease.

Eissa, I. M., N. B. Abu Hussein, A. E. Habib, and Y. M. El Sayed, "Examining Delay Intervals in the Diagnosis and Treatment of Primary Open Angle Glaucoma in an Egyptian Population and Its Impact on Lifestyle.", Journal of ophthalmology, vol. 2016, pp. 7012826, 2016. Abstract

. To examine causes as well as extent of delay in diagnosis and treatment of primary open angle glaucoma patients in a sample of Egyptians. . 440 patients with primary open angle glaucoma were interviewed to evaluate delay in their diagnosis and treatment. The extent and cause of delay were investigated. The total delay interval, if any, was correlated with socioeconomic and other factors. . The median total delay was one year, with 50% of patients having a total delay of 1 year or less, of which 25% exhibited zero total delay. 25% of patients had a delay ranging from 1 to 3 years, and 25% had a total delay ranging from 3 to 27 years. Diagnostic delay accounted for 43.03% of cases. Longer delays were met in patients with certain socioeconomic factors. Patients with a positive family history of glaucoma displayed shorter delay periods. . Significant delay in the diagnosis and treatment of glaucoma was found. Poor socioeconomic status seems to hinder timely diagnosis and treatment of POAG. Certain socioeconomic factors seem to correlate with the extent of delay. More effort is thus needed to subsidize the cost of investigations and treatment for glaucoma patients.

Hussein, N. A., I. Eissa, and A. A. Abdel-Kader, "Analysis of Factors Affecting Patients’ Compliance to Topical Antiglaucoma Medications in Egypt as a Developing Country Model", Journal of Ophthalmology, vol. 2015, issue ID 234157, pp. 7 pages, 2015. hindawi_article.pdf
Hosny, M. H., M. A. Zayed, A. M. M. Shalaby, and I. M. Eissa, "Effect of Intracameral Bevacizumab Injection on Corneal Endothelial Cells: An In Vivo Evaluation", JOURNAL OF OCULAR PHARMACOLOGY AND THERAPEUTICS, vol. 25, issue 6, pp. 513-517, 2009. shalaby_paper.pdf