Objective:

To evaluate the potential of lacrimal gland color Doppler ultrasonography (LGCDUS) in identifying early primary Sjögren’s Syndrome (pSS) by capturing morphologic and hemodynamic changes.

Key Findings:

• Early-stage pSS eyes showed significantly higher EDV and lower RI, indicating increased perfusion.
• Peak systolic velocity and minor-axis enlargement trended upward but were not statistically significant after correction.
• EDV was the only independent predictor of disease status with an AUC of 0.764, sensitivity of 62.8%, and specificity of 80.8%.
• Good to excellent inter-observer agreement across all measured parameters.

Interpretation:

The findings suggest that hemodynamic changes in the lacrimal gland may precede structural changes in early pSS, potentially offering a non-invasive diagnostic tool.

Limitations:

• Study is small and retrospective, limited to early-stage disease.
• Exclusion of patients with systemic comorbidities or immunosuppressive therapy.
• Lack of correlation between imaging and lacrimal histopathology.

Conclusion:

LGCDUS may provide a fast, non-invasive method to detect early gland involvement in pSS, complementing existing diagnostic approaches, though further research is needed for routine application.