In-Office Procedures · Diagnostic

Sjo: Advanced Sjogren's Syndrome Diagnostic Panel

Seven-biomarker blood panel for early detection of Sjögren's syndrome, including three novel markers that identify the disease years before traditional tests turn positive.

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Written by the Dry Eye Rescue clinical team | Medically reviewed by the DER Medical Advisory Panel | Last updated June 2026

Key points

  • Seven-biomarker blood panel for early detection of Sjogren's syndrome.
  • Combines traditional markers with novel ones that can flag disease earlier.
  • Run from an in-office finger-prick sample, processed by the lab.
  • Useful when aqueous-deficient dry eye warrants a systemic workup.

What it does

The Sjö test (Immco Diagnostics) is an advanced laboratory diagnostic panel for detecting Sjögren's syndrome in patients presenting with dry eye. A small blood sample, obtained in-office via finger prick or standard venipuncture, is sent to Immco's laboratory, where it is analyzed for seven biomarkers:

  • Traditional markers: SS-A/Ro, SS-B/La, Antinuclear Antibody (ANA), Rheumatoid Factor (RF)
  • Novel early-detection markers (proprietary): Salivary Gland Protein-1 (SP-1), Carbonic Anhydrase-6 (CA-6), Parotid Secretory Protein (PSP)

The three novel biomarkers are gland-specific autoantibodies that appear earlier in the disease course than traditional markers, enabling detection in patients who test negative by conventional SS panels. The cumulative sensitivity of the full Sjö panel is 89.9% across four clinical validation studies (248 sera samples), with specificity of 78.7%.

Why it matters in a dry eye practice

Sjögren's syndrome affects an estimated 4 million Americans and takes an average of nearly seven years to diagnose from symptom onset. The vast majority of undiagnosed patients first present to an eye care provider with dry eye symptoms, making the dry eye practice the single best point of early detection. Sjögren's patients require a fundamentally different treatment approach (aqueous-deficient dry eye management, systemic referral, biologics) than evaporative MGD. Misclassifying them as standard MGD leads to years of inadequate care.

Clinical evidence

  • Shen et al. (2015), Clinical Ophthalmology, Multi-study validation showing the Sjö panel identified SS patients who tested negative on traditional SS-A/SS-B panels, with cumulative sensitivity of 89.9%. PMC, Clinical Ophthalmology
  • Beckman et al. (IOVS), Novel Sjögren's Antibodies in Dry Eye Patients, Study of 68 dry eye patients showing novel biomarkers (SP-1, CA-6, PSP) detected SS in patients with negative traditional panels. Investigative Ophthalmology & Visual Science
  • Bohrium multi-disciplinary review (2024), Concluded optometrists can identify Sjögren's patients earlier in their dry eye population using the Sjö advanced diagnostic test, enabling interdisciplinary referral sooner in the disease course. Bohrium

Who to test

Consider Sjö testing in dry eye patients with:

  • Aqueous-deficient pattern on Schirmer (≤5 mm), particularly younger women
  • Severe symptoms disproportionate to observable signs
  • Dry mouth, joint pain, or fatigue accompanying dry eye complaints
  • Inadequate response to lipid-layer-directed treatments
  • Family history of autoimmune disease

Manufacturer

Immco Diagnostics, Sjö Diagnostic Test

Sources are linked inline above. Device descriptions reference FDA clearance status, published peer-reviewed studies, and manufacturer data. Clinical outcomes are not a guarantee of individual results. Review full prescribing information, the IFU, and FDA clearance documentation for each device before use.

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