Читать книгу Graves' Orbitopathy - Группа авторов - Страница 31

At present we do not know the value of assessing all patients using these additional methods as no data relate to patients with all grades of severity. Of course all patients in routine clinical practice can have disease duration and soft-tissue evaluation without any additional cost or facilities. At present the place for the other methods described will depend partly on their availability and cost, and partly on the presenting features of an individual patient. There is no proven necessity for additional tests in patients with a very high CAS and severe disease or conversely a very low CAS and very mild disease, as in neither circumstance would the management be influenced. For those patients who have significant but not sight-threatening disease and a low CAS, current evidence favours the use of additional tests if disease-modifying agents are to be considered. An alternative approach is simply to give a short trial of treatment provided the anticipated morbidity for that patient is acceptable.