Ophthalmologic and serologic predictors of positive minor salivary gland biopsy in suspected Sjögren's disease.

To examine the relation between histopathology, ANA subtypes, and high-resolution dry eye analysis in treatment-naive patients evaluated for Sjögren's disease suspicion in a referral center. Between October 2022 and December 2023, 231 patients who underwent minor salivary gland biopsies were included in the study. Patients were grouped according to their Chisholm and Mason (CM) biopsy scores. Non-invasive ocular surface evaluations and ANA subtype analysis, according to the International Consensus on ANA Patterns (ICAP), were also conducted. Meibomian gland (MG) atrophy was significantly higher (p 0.02) in the positive biopsy group (OR 1.02), although it was a weaker predictor than other parameters. Anti-SSA positivity was markedly correlated with positive biopsy results. However, subtype analysis did not show any significant correlation. In predicting CM scores > 2, ANA positivity was 2.1-fold, SSA positivity was 3.6-fold, Schirmer positivity was 12, fivefold, positive ocular OSS scores were fourfold, limbal redness, and NiBUT less than 10 s were 2.4-fold more significant determinant factors. Our results confirm that the Schirmer test and classical serologic markers are still irreplaceable. We believe that novel measurement techniques that enable faster, non-invasive analyses with advanced technology will facilitate the differential diagnosis of Sjögren's disease in patients with dry eyes.