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Behçet’s disease ocular attack score 24: evaluation of ocular disease activity before and after initiation of infliximab

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

We developed a novel scoring system for uveitis due to Behçet’s disease (BD), termed Behçet’s disease ocular attack score 24 (BOS24), and examined its validity and usefulness by estimating changes in ocular disease activities both before and after initiation of infliximab therapy.

Methods

BOS24 consists of a total 24 points divided into 6 parameters of ocular inflammatory symptoms. To examine the validity of our scoring system, 5 uveitis specialists examined the severity of 50 ocular attacks in clinical charts using both our system and a physician’s impression score (grade 1–10). In addition, ocular disease activities both before and after initiation of infliximab were retrospectively examined in 150 cases of ocular BD using BOS24.

Results

The average BOS24 for the 5 doctors was highly correlated with the average physician’s impression score (p < 0.0001), whereas the coefficient of variance for BOS24 among doctors was much lower than that for the physician’s impression score (p < 0.0001). Summation of BOS24 over a 6-month period (BOS24-6M) was significantly reduced after starting infliximab therapy (p < 0.0001). The average BOS24 for individual ocular attacks was also significantly decreased after starting infliximab, with scores for the posterior pole and fovea notably improved.

Conclusions

BOS24 was highly related to severity noted by the physician’s impression and had a low level of variability among the examined doctors. Using our novel scoring system, infliximab therapy was shown to reduce not only the frequency of ocular attacks, but also the severity of each attack. BOS24 is a promising tool for evaluating ocular BD activities.

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Acknowledgments

This study was supported in part by a Grant-in-Aid for Science Research for Behçet’s disease from the Ministry of Health, Labor and Welfare of Japan (No. 087100000332).

Conflicts of interest

T. Kaburaki, None; K. Namba, None; K. Sonoda, None; T. Kezuka, Lecture fees (Mitsubishi Tanabe Pharma); H. Keino, None; T. Fukuhara, None; K. Kamoi, None; K. Nakai, None; N. Mizuki, None; N. Ohguro, None; The Ocular Behçet Disease Research Group of Japan, None.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Toshikatsu Kaburaki

  2. Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan

    Kenichi Namba & Takako Fukuhara

  3. Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan

    Koh-hei Sonoda

  4. Department of Ophthalmology, Tokyo Medical University School of Medicine, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan

    Takeshi Kezuka

  5. Department of Ophthalmology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan

    Hiroshi Keino

  6. Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Takako Fukuhara

  7. Department of Ophthalmology, Tokyo Medical and Dental University School of Medicine, Yushima 1-5-45, Nishi 7, Bunkyo-ku, Tokyo, 113-8510, Japan

    Koju Kamoi

  8. Department of Ophthalmology, Osaka University Graduate School of Medicine, Yamadaoka 2-2, Suita, Osaka, 565-0871, Japan

    Kei Nakai

  9. Department of Ophthalmology, Yokohama City University School of Medicine, Fukuura 3-9, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan

    Nobuhisa Mizuki

  10. Department of Ophthalmology, Osaka Koseinenkin Hospital, 4-2-78 Fukushima, Fukushima-ku, Osaka, 553-0003, Japan

    Nobuyuki Ohguro

Authors
  1. Toshikatsu Kaburaki
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  2. Kenichi Namba
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  3. Koh-hei Sonoda
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  4. Takeshi Kezuka
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  5. Hiroshi Keino
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  6. Takako Fukuhara
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  7. Koju Kamoi
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  8. Kei Nakai
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  9. Nobuhisa Mizuki
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  10. Nobuyuki Ohguro
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Consortia

The Ocular Behçet Disease Research Group of Japan

Corresponding author

Correspondence to Toshikatsu Kaburaki.

Additional information

The members of the Ocular Behçet’s Disease Research Group of Japan are listed in the Appendix.

Appendix: Group information

Appendix: Group information

The members of the Ocular Behçet’s Disease Research Group of Japan are as follows:

Hokkaido University, Sapporo: Kenichi Namba M.D., Ph.D.*, Shigeaki Ohno M.D., Ph.D. and Nobuyoshi Kitaichi M.D., Ph.D.

Kyorin University, Tokyo: Hiroshi Keino M.D., Ph.D.*, Annabelle A. Okada M.D., Ph.D. and Takayo Watanabe M.D., Ph.D.

Kyushu University, Fukuoka: Takako Fukuhara M.D.*, Atsunobu Takeda M.D., Ph.D. and Tatsuro Ishibashi M.D., Ph.D.

Osaka Koseinenkin Hospital, Osaka: Nobuyuki Ohguro M.D., Ph.D.* and Kenji Yawata M.D.

Osaka University Graduate School of Medicine, Osaka: Kei Nakai M.D., Ph.D.* and Chiharu Iwahashi M.D., Ph.D.

Tokyo Medical and Dental University, Tokyo: Koju Kamoi M.D., Ph.D.*, Manabu Mochizuki M.D., Ph.D. and Sunao Sugita M.D., Ph.D.

Tokyo Medical University, Tokyo: Takeshi Kezuka M.D., Ph.D.* and Hiroshi Goto M.D., Ph.D.

University of Tokyo, Tokyo: Toshikatsu Kaburaki M.D., Ph.D.*, Mitsuko Takamoto M.D., Ph.D. and Hisae Nakahara M.D.

Yamaguchi University, Yamaguchi: Koh-hei Sonoda M.D., Ph.D.* and Yukiko Kondo MD, PhD.

Yokohama City University, Yokohama: Nobuhisa Mizuki M.D., Ph.D.*, Etsuko Shibuya M.D., Ph.D. and Ikuko Kimura M.D.

*The Writing Group for the Ocular Behcet’s Disease Research Group of Japan.

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Kaburaki, T., Namba, K., Sonoda, Kh. et al. Behçet’s disease ocular attack score 24: evaluation of ocular disease activity before and after initiation of infliximab. Jpn J Ophthalmol 58, 120–130 (2014). https://doi.org/10.1007/s10384-013-0294-0

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  • DOI: https://doi.org/10.1007/s10384-013-0294-0

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