Does lacrimal gland ultrasound discriminate between Sjögren's disease and non-Sjögren's sicca patients?

Abstract

Objective: To investigate the performance of colour Doppler lacrimal gland ultrasound (LGUS CD) for discriminating Sjögren's disease (SjD) from non-SjD sicca patients under routine clinical practice conditions.

Method: Forty patients with clinically suspected SjD underwent ocular function tests [Schirmer's test, ocular staining score (OSS)] and LGUS CD evaluation. Ultrasound images and videos were scored for both lacrimal glands using the Outcome Measures in Rheumatology (OMERACT) CD scoring system (range 0-3). Subsequently, a total score (range 0-6) was calculated for each patient. Sensitivity and specificity of LGUS CD and ocular function tests were calculated to predict SjD classification according to 2016 American College of Rheumatology/European Alliance of Associations for Rheumatology (ACR/EULAR) classification criteria. Construct validity of LGUS CD was assessed by determining Spearman's correlation coefficients between LGUS CD, Schirmer's test, and OSS.

Results: Twenty-three patients were classified with SjD and 17 as non-SjD sicca patients. LGUS CD sensitivity was 57% and specificity was 53% for prediction of classification according to 2016 ACR/EULAR classification criteria for SjD. Total LGUS CD score of both eyes and the individual LGUS CD score of the left and right eye did not differ significantly between SjD and non-SjD sicca patients. None of the ACR/EULAR classification criteria differed significantly between the groups with high and low LGUS CD scores. Poor correlations were determined between LGUS CD and ocular function tests (ρ = 0.028-0.187).

Conclusion: LGUS CD demonstrated similar characteristics in SjD and non-SjD sicca patients, suggesting limited discriminatory value. Refined ultrasonographic scoring systems are needed to improve differentiation between these patient groups.