Mostafa M.E. Hamza’s research while affiliated with Cairo University and other places

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Publications (5)


Monthly Intravitreal Infliximab in Behçet's Disease Active Posterior Uveitis: A Long-Term Safety Study
  • Article

December 2020

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58 Reads

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18 Citations

Retina

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Mostafa M Hamza

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Purpose: To study the safety of extended monthly intravitreal infliximab injections in patients with active posterior uveitis in Behcet's disease (APUBD). Methods: This is a prospective, interventional, noncomparative, open-label, pilot study of 9 monthly intravitreal infliximab injections (1mg/0.05ml) for twenty-two eyes of 16 patients with APUBD. Control of inflammation and visual outcomes were assessed, and ocular complications were monitored during the study period. Results: Successful treatment was achieved in 7 eyes (35%) and failure was encountered in 13 eyes (65%). Only seven eyes of 6 patients (35%) had completed the study and achieved complete resolution of inflammation with improved BCVA, and no complications. Failure was either due to inability to control the inflammation in 9 eyes (45%) or development of exacerbation of inflammation in 4 eyes (20%). Four eyes developed severe immunological reaction from the drug following first (n=1), second (n=2), and third (n=1) injections and had to discontinue the injections. Kaplan-Meier survival analysis showed that the mean estimated time to failure was 3.3±0.2 months and all failed eyes required revision of their systemic immunotherapy to control the ocular inflammation. Conclusion: Intravitreal infliximab for APUBD was associated with a high complication rate and failure to control inflammation in the majority of eyes. It should not be considered a substitute to systemic therapy.


Change in Ophthalmology Practice during COVID-19 Pandemic: Egyptian Perspective

July 2020

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83 Reads

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12 Citations

Ophthalmologica

Purpose: To assess the impact of COVID-19 pandemic on ophthalmology practice in Cairo metropolitan area. Methods: A cross sectional observational analytic study among ophthalmologists practicing in different hospitals in Cairo metropolitan area. The data was collected through a self-administered questionnaire covering general measures taken during practice. Results: The questionnaire was sent to 250 ophthalmologists with 82% response. Most of the participants were concerned about the economic impact of the pandemic, as there is 60-80% reduction in the flow of patients with consequent 80-100% reduction in the surgical cases. Most of the participants have access to protective personal equipments, and safety protocols are followed, especially by the older ophthalmologists. So, surgeons are willing to perform elective surgeries taking strict safety protocols (70.8%, 42.6%, 18.8% for the refractive surgeons, corneal surgeons, retinal surgeons respectively, p=0.00). Furthermore, 63.9% of the participants,especially the young ophthalmologists, are willing to see COVID-19 patients and operate on them if needed. Conclusion: COVID-19 pandemic could go on for months or even years with a significant impact on the ophthalmology practice. Trying to keep the balance between safety and economic burdens, the majority of ophthalmologists are willing to see elective patients and operate on an urgent COVID-19 patient, with adherence to the safety protocols.


Fig. 1. Shows changes in the mean BCVA in logMARs and mean CFT OCT in microns throughout the study. Mean BCVA in logMARs at baseline = 0.94 ± 0.32 (20/160), Week 2 = 0.60 ± 0.18 (20/80), Week 4 = 0.41 ± 0.18 (20/50), Week 6 = 0.44 ± 0.17 (20/ 50), Week 8 = 0.38 (20/50), Week 12 = 0.51 ± 0.23 (20/63), and Week 18 = 0.36 ± 0.19 (20/40). 
Table 1 . Baseline Patients' Demographics; Ocular Clinical Findings (Both Eyes); and Topical and Systemic Treatments
Fig. 2. Changes in the mean grades in vitreous haze throughout the study. 
Table 2 . Mean BCVA in logMAR (Snellen), CFT OCT, IOP, Vitreous Haze Grading, and Number of Patients With Retinitis, Vasculitis, and Papillitis at Baseline and Each Study Visit
Fig. 3. Changes in the number of patients with vasculitis, retinitis, and papillitis throughout the study period. 

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Intravitreal infliximab in refractory uveitis in Behcet's disease: A safety and efficacy clinical study
  • Article
  • Full-text available

June 2016

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338 Reads

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38 Citations

Retina

Purpose: To assess the safety and efficacy of intravitreal infliximab (1 mg/0.05 mL) in patients with refractory posterior uveitis in Behcet's disease. Methods: Twenty patients were included in this study. Best corrected visual acuity (BCVA), vitreous haze (graded 0-4), vasculitis, retinitis, and papillopathy (presence or absence) were assessed at baseline, Day 1 and Week 2, 4, 6, 8, 12, and 18. Optical coherence tomography (OCT) central foveal thickness, fluorescein angiography, and flash electroretinogram were done at baseline and 4, 12, and 18 weeks. Results: Mean baseline logMAR BCVA was 0.94 (20/160), had improved significantly by Week 2 to 0.6 (20/80) (P < 0.0001), and reached 0.36 (20/40) by Weeks 18 with three injections (P < 0.0001). Mean central foveal thickness OCT decreased significantly from baseline 361 μm to 180 μm at the end of follow-up (P < 0.0001). Profound decrease in mean vitreous haze gradings from two to 0.2 by the end follow-up (P < 0.05). There was a significant reduction in the number of patients with vasculitis (15 at baseline to 1 weeks at 18 weeks), retinitis (nine at baseline to none at 4 weeks), and papillitis (two at baseline to none at 4 weeks) (P < 0.05). No significant electrophysiological changes or ocular adverse inflammatory reactions were observed during the study period. Conclusion: Intravitreal infliximab appeared to be safe and effective in treating uveitis in Behcet's disease and should be considered as an alternative to systemic therapies.

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Intravitreal Infliximab for Sight-Threatening Relapsing Posterior Uveitis in Behçet disease: A Safety and Efficacy Clinical Study.

September 2014

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2 Reads

Purpose: To assess the safety and efficacy of intravitreal infliximab (1 mg/0.05 mL) in patients with refractory posterior uveitis in Behcet’s disease. Methods: Twenty patients were included in this study. Best corrected visual acuity (BCVA), vitreous haze (graded 0–4), vasculitis, retinitis, and papillopathy (presence or absence) were assessed at baseline, Day 1 and Week 2, 4, 6, 8, 12, and 18. Optical coherence tomography (OCT) central foveal thickness, fluorescein angiography, and flash electroretinogram were done at baseline and 4, 12, and 18 weeks. Results: Mean baseline logMAR BCVA was 0.94 (20/160), had improved significantly by Week 2 to 0.6 (20/80) (P , 0.0001), and reached 0.36 (20/40) by Weeks 18 with three injections (P , 0.0001). Mean central foveal thickness OCT decreased significantly from baseline 361 mm to 180 mm at the end of follow-up (P , 0.0001). Profound decrease in mean vitreous haze gradings from two to 0.2 by the end follow-up (P , 0.05). There was a significant reduction in the number of patients with vasculitis (15 at baseline to 1 weeks at 18 weeks), retinitis (nine at baseline to none at 4 weeks), and papillitis (two at baseline to none at 4 weeks) (P , 0.05). No significant electrophysiological changes or ocular adverse inflammatory reactions were observed during the study period. Conclusion: Intravitreal infliximab appeared to be safe and effective in treating uveitis in Behcet’s disease and should be considered as an alternative to systemic therapies.


Intravitreal Infliximab for Sight-Threatening Relapsing Posterior Uveitis in Behçet disease: A Safety and Efficacy Clinical Study.

August 2014

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1 Read

Purpose: To assess the safety and efficacy of intravitreal infliximab (1 mg/0.05 mL) in patients with refractory posterior uveitis in Behcet’s disease. Methods: Twenty patients were included in this study. Best corrected visual acuity (BCVA), vitreous haze (graded 0–4), vasculitis, retinitis, and papillopathy (presence or absence) were assessed at baseline, Day 1 and Week 2, 4, 6, 8, 12, and 18. Optical coherence tomography (OCT) central foveal thickness, fluorescein angiography, and flash electroretinogram were done at baseline and 4, 12, and 18 weeks. Results: Mean baseline logMAR BCVA was 0.94 (20/160), had improved significantly by Week 2 to 0.6 (20/80) (P , 0.0001), and reached 0.36 (20/40) by Weeks 18 with three injections (P , 0.0001). Mean central foveal thickness OCT decreased significantly from baseline 361 mm to 180 mm at the end of follow-up (P , 0.0001). Profound decrease in mean vitreous haze gradings from two to 0.2 by the end follow-up (P , 0.05). There was a significant reduction in the number of patients with vasculitis (15 at baseline to 1 weeks at 18 weeks), retinitis (nine at baseline to none at 4 weeks), and papillitis (two at baseline to none at 4 weeks) (P , 0.05). No significant electrophysiological changes or ocular adverse inflammatory reactions were observed during the study period. Conclusion: Intravitreal infliximab appeared to be safe and effective in treating uveitis in Behcet’s disease and should be considered as an alternative to systemic therapies.

Citations (3)


... Intravitreal administration of IFX has been investigated as an alternative route of administration. However, it has not demonstrated significant superiority over systemic administration with possible adverse events associated with intravitreal IFX administration including mainly severe immunological reactions leading thus to treatment discontinuation [86,87]. ...

Reference:

Recent advances in the diagnosis and management of Behçet’s syndrome uveitis
Monthly Intravitreal Infliximab in Behçet's Disease Active Posterior Uveitis: A Long-Term Safety Study
  • Citing Article
  • December 2020

Retina

... Navazující publikované studie, které mapovaly situaci v jednotlivých zemích a za specifických podmínek např. v Turecku [7,8], Egyptě [9], či USA [10], toto zjištění potvrdily. Ve světové literatuře se také objevily práce, které poukázaly na možné ovlivnění výsledků testování na počítačovém perimetru (PP) při současném použití ochrany nosu [11][12][13]. ...

Change in Ophthalmology Practice during COVID-19 Pandemic: Egyptian Perspective
  • Citing Article
  • July 2020

Ophthalmologica

... Hamza et al. demonstrated the safety and efficacy of a single 1 mg/0.05 ml intravitreal IFX injection in 20 patients with refractory uveitis due to BD [37]. At 18 weeks of follow-up, they observed statistically significant improvements in mean visual acuity, reductions in mean central macular thickness, and decreased mean vitreous haze scores. ...

Intravitreal infliximab in refractory uveitis in Behcet's disease: A safety and efficacy clinical study

Retina