Ocular Surface Staining Score and Salivary Gland Scintigraphy in Patients with Primary Sjogren's Syndrome

Purpose: To analyze the correlation between the ocular surface staining score and indices of salivary gland scintigraphy in patients with primary Sjogren's syndrome and dry eye symptoms, and to evaluate the diagnostic value of these indices. Methods: The patients were 51 adults with primary SjOgren's syndrome or non-SjOgren's syndrome plus dry eye symptoms, who were referred to our ophthalmology clinic for evaluation of the degree of dry eye at the Department of Rheumatology, from July 2017 to April 2019. The Mann-Whitney U test and student's Mest were used for analyzing the ocular surface staining score and quantitative indices of salivary gland scintigraphy, respectively, in the primary Sjogren's syndrome and non-SjOgren's syndrome patients. Spearman correlation was used to analyze the correlations of ocular surface staining score with salivary scintigraphy indices. Results: The ocular surface staining score (p = 0.021), parotid gland excretion fraction (p = 0.022), and submandibular gland excretion fraction (p = 0.045) were significantly different between the primary SjOgren's syndrome and non-SjOgren's syndrome patients. The submandibular gland uptake ratio (r = -0.369, p = 0.008) and submandibular excretion fraction (r = -0.359, p = 0.010) were significantly negatively correlated with ocular surface staining scores. Conclusions: The ocular surface staining score was identified as the gold standard for evaluating the degree of dry eye in primary Sjogren's syndrome patients. If salivary gland dysfunction is identified by salivary gland scintigraphy, ocular surface staining should be performed to confirm the presence of ocular surface lesions, regardless of the presence of dry eye symptoms.