The Severity Classification of Graves' Orbitopathy is a clinical tool designed for the assessment and stratification of Graves' orbitopathy (GO), a common manifestation of Graves' disease. This tool aids in the identification of the severity of the condition, which is crucial for determining the appropriate therapeutic approach.
The primary components of this classification system include six key clinical features: lid retraction, soft tissue involvement, exophthalmos, diplopia, corneal injury, and dysthyroid optic neuropathy. Each of these features is evaluated and assigned a score based on its severity.
Lid retraction and exophthalmos are scored based on their extent, with a higher score for lid retraction of 2 mm or more and exophthalmos of 3 mm or more. Soft tissue involvement and diplopia are scored based on their severity, with a higher score for moderate or severe soft tissue involvement and inconstant or constant diplopia. Corneal injury is scored based on its responsiveness to lubricants or the presence of corneal breakdown, with a significantly higher score for corneal breakdown. Dysthyroid optic neuropathy is scored based on its presence or absence, with a significantly higher score if present.
The total score is then used to classify the severity of Graves' orbitopathy. 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. This classification system thus provides a structured approach to assess the severity of GO, guiding clinicians in the management and treatment of this condition.
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.
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