Severity classification of Graves' orbitopathy

The Severity Classification of Graves' Orbitopathy is a clinical tool designed for stratifying the severity of Graves' orbitopathy (GO), a common manifestation of Graves' disease. The tool aids in the identification of patients with sight-threatening GO, moderate-to-severe GO, and mild GO, thereby guiding appropriate management strategies. The primary components of the severity classification include lid retraction, soft tissue involvement, exophthalmos, diplopia, corneal injury, and dysthyroid optic neuropathy. Each component is evaluated and assigned a score based on the extent of the manifestation. For instance, lid retraction of less than 2 mm is scored differently from lid retraction of 2 mm or more. Similarly, the presence of dysthyroid optic neuropathy is scored differently from its absence. The total score is determined by summing the scores of all components. A score of 25 or more indicates sight-threatening GO, a score of 6 or more indicates moderate-to-severe GO, and a score of 5 or less indicates mild GO. The severity classification of Graves' Orbitopathy thus provides a systematic approach to assess the severity of GO, facilitating timely intervention and management.

Reference

L Bartalena, G J Kahaly, L Baldeschi et al. The 2021 European Group on Graves' orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves' orbitopathy. Eur J Endocrinol. 2021 Aug 27;185(4):G43-G67.