Thyroid associated ophthalmopathy is an organ specific autoimmune disease associated with the thyroid gland. The course of the disease was i
Thyroid associated ophthalmopathy is an organ specific autoimmune disease associated with the thyroid gland. The course of the disease was in the early stage of the 2 stages of the active phase, mainly manifested as the infiltration of lymphocytes, edema and activation of fibroblasts. Because of the different therapeutic effects of immunosuppressive therapy or radiotherapy at different stages of the disease, it is important to find some methods to evaluate the activity of the eye disease, which is helpful for the selection of treatment time and the estimation of prognosis.
Clinical activity score (clinical activity score, CAS):
Since 1980s, according to the clinical symptoms of inflammation, Mourits et al. Proposed the clinical activity score of thyroid associated ophthalmopathy (CAS). Based on the typical symptoms and signs of inflammation, such as red, swelling, and pain, the author put forward the standard of judging the activity of thyroid associated ophthalmopathy, a total of 10 items, each with a total score of 1 points, a total of 10 points. The CAS score (more than 4/10) had 80% positive predictive value, negative predictive value but only 64%.
Clinical activity score of thyroid associated ophthalmopathy
After 4 weeks of eyeball or retrobulbar pain or pressure
Eye movements during the last 4 weeks
Conjunctival hyperemia (at least 1 quadrants)
Within 1 to 3 months, the degree of exophthalmos increased by more than 2mm
1 ~ 3 months, the direction of movement of the eye reduced by more than 5 degrees
1 ~ 3 months corrected visual acuity decreased by more than 1 lines
Predictors of thyroid associated ophthalmopathy activity: the CAS score is not less than 4; the blood or urine GAG level
L; in A type ultrasound measurement of ocular reflectivity is less than or equal to 40%; the NMR T2 relaxation time prolonged; the ball
The organization of indium labeled octreotide uptake.
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