[A dialectical analysis of the clinical activity score for thyroid-associated ophthalmopathy]

The clinical activity score (CAS) for the thyroid-associated ophthalmopathy (TAO) evaluation has advantages such as simplicity and practicality for clinical use, but it also has limitations. Based on the formulation and development of the CAS, this article analyzes five aspects: design limitations, ethnic differences, comparison with the VISA (vision, inflammation, strabismus, and appearance/exposure) classification, controversies regarding CAS cutoff values, and the lack of objectivity in the CAS. It emphasizes that clinicians should comprehensively and dialectically evaluate the CAS by integrating the disease course, severity, and harmfulness of TAO, so as to correctly distinguish TAO stages, provide appropriate treatments, achieve favorable therapeutic effects, and ultimately improve the clinical management of TAO.