Clinical Activity Score (Graves' orbitopathy)
Endocrinology
Also known as: Clinical Activity Score (CAS) und EUGOGO-Schweregrad der endokrinen Orbitopathie · Klinik Aktivite Skoru (Graves oftalmopatisi) · Clinical Activity Score (CAS) dell'orbitopatia di Graves · Clinical Activity Score (CAS) de l'orbitopathie basedowienne · Clinical Activity Score (CAS) de la orbitopatía de Graves · Clinical Activity Score (CAS) and EUGOGO severity in Graves' orbitopathy
What it is for
The Clinical Activity Score (CAS) rates inflammatory activity of Graves' orbitopathy (thyroid eye disease): one point per sign present. Activity and severity are graded separately.
Classification
| Category | Description |
|---|---|
| CAS initial visit (7 items) | spontaneous retrobulbar pain; pain on attempted eye movement; eyelid redness; conjunctival redness; eyelid swelling; chemosis; inflammation (swelling) of the caruncle or plica. |
| CAS follow-up (10 items) | the 7 items plus, over 1–3 months: proptosis increase ≥2 mm; decrease in eye movements ≥8°; decrease in visual acuity ≥1 Snellen line. |
| Activity | CAS ≥3 of the 7 initial items = active disease. |
| EUGOGO severity – mild | limited impact on daily life. |
| EUGOGO severity – moderate-to-severe | no sight threat, but clinically meaningful lid, soft-tissue, proptosis or diplopia involvement with impact on daily life. |
| EUGOGO severity – sight-threatening | dysthyroid optic neuropathy (DON) and/or corneal breakdown. |
Source
Clinical activity score as a guide in the management of patients with Graves' ophthalmopathy
Clin Endocrinol (Oxf) 1997;47:9–14 (Mourits MP et al.)
DOI: 10.1046/j.1365-2265.1997.2331047.x
PMID: 9302365
- Edition
- CAS (Mourits 1997, 7-item initial / 10-item follow-up) and EUGOGO severity grading as used in the EUGOGO 2021 guideline
- Checked on
Summary of the published classification in our own words. Not a substitute for the original publication.
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