甲状腺相关眼病严重度分级和分期现状及存在的问题

Research status and issues of severity grading and staging of thyroid-associated ophthalmopathy

甲状腺相关眼病(TAO)是成人常见的眼眶疾病,可导致一系列眼部症状及体征,严重影响患者的视觉健康和生活质量。准确把握疾病病程进展、客观评价其严重程度和活动性对制定合理的治疗方案及改善患者的预后至关重要。TAO的分级分期方法在不断改进,在对眼病的主观症状和体征的描述性评价中,国际上先后提出甲状腺相关眼征分级(NOSPECS)、临床活动度评分(CAS)、VISA及EUGOGO四大分级分期系统,各系统之间既有相同之处,也有各自的侧重点。而近年来,随着科技的飞速发展,影像技术及实验室检查等客观评价方法对TAO的分级分期起到了不可忽视的作用。其中,眼眶CT和MRI的应用使得对疾病的定量分析取得重大突破。TAO分级分期方法的不断总结,为TAO病情判断、治疗方案选择和疗效预测提供参考和指导。

Thyroid-associated ophthalmopathy(TAO)is a common orbital disease in the adults,which leads to a series of ocular symptoms and signs,seriously affecting the visual function and life quality of patients.Grasping the disease progression accurately and evaluating the severity and activity of TAO objectively play a crucial role in improving the management and prognosis of TAO patients.Grading and staging methods of TAO have been constantly improved.In the descriptive evaluation of subjective symptoms and signs of TAO,four international grading and staging systems with similarities and different focuses,namely,NOSPECS,CAS,VISA and EUGOGO,have been proposed successively.In recent years,with the rapid development of science and technology,objective evaluation methods such as imaging technology and laboratory examination have played an important role in the grading and staging of TAO.Among them,the application of orbital CT and MRI has made a great breakthrough in quantitative analysis of the disease.Continuous summary of grading and staging methods of TAO can contribute to the guidance for improving diagnosis,treatment and prognosis of TAO.