Evaluation of Ultrasound Biomicroscopy Combined with Color Doppler Flow Imaging in the Diagnosis of Primary Lacrimal Canaliculitis.

Purpose : To explore the performance of ultrasound biomicroscopy (UBM) and color Doppler flow imaging (CDFI) in the diagnosis of primary lacrimal canaliculitis. Methods : Subjects with relevant symptoms of canaliculitis were prospectively recruited. UBM and CDFI were performed for presumptive diagnosis. Microbiology and histopathology were performed for definitive diagnosis. Results : A total of 37 cases were recruited, including 25 cases of canaliculitis and 12 cases of non-canaliculitis. Pathogens were isolated in 13 canaliculitis cases, and the leading pathogens were Actinomyces (4 cases) and Streptococcus (4 cases). UBM and CDFI identified 24 canaliculitis cases (sensitivity = 96%) and 11 non-canaliculitis cases (specificity = 92%). The predictive factors for canaliculitis were lumen wall thickness >0.25 mm ( P = .019) and intracanalicular concretions ( P = .010). Other typical features were enlarged lumen (2.16 ± 0.25 mm) and hot-wheel sign-on CDFI (84%). These image findings were congruent with histopathologic changes. Conclusion : Ultrasonography is a valuable tool to assist the diagnosis of canaliculitis.(Clinical trial registration number: ChiCTR1900025411).