The Graves' Orbitopathy Clinical Activity Score, commonly referred to as the CAS Score, is a clinical calculator used specifically in patients with Graves' disease, an autoimmune disorder that affects the thyroid. This scoring system is particularly useful in assessing the activity of Graves' orbitopathy, a condition characterized by inflammation and swelling of the tissues around the eyes, leading to symptoms such as bulging eyes, double vision, and eye discomfort.
The CAS Score is used to quantify the severity of Graves' orbitopathy and monitor its progression over time. It is based on the evaluation of seven clinical signs: pain in primary gaze, pain with eye movement, redness of the eyelids, redness of the conjunctiva, swelling of the eyelids, swelling of the caruncle or plica, and swelling of the conjunctiva (chemosis). Each sign is scored as 0 (absent) or 1 (present), and the total score ranges from 0 to 7.
The CAS Score is not applicable to patients without Graves' disease or those without signs of orbitopathy. It also may not be suitable for patients with other eye conditions that could confound the assessment of the clinical signs used in the score.
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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