Eyeworld

EW CORNEA 88 September 2017 ly stages of the disease. Thus, there may not be any "true" asymmetric KC since BRI indicated that both eyes were affected. Dr. Hovanesian: I selected this paper because I found the Bowman's rough- ness index (BRI) to be an interesting new evaluation for keratoconus risk. Naturally, further study is needed, but we hope to gain better predictive power in identifying eyes at risk of ectasia in our refractive patients. Prevalence of meibomian gland atrophy in a pediatric population Madelyn Stevens, BA, Preeya Gupta, MD Purpose: Among adult patients with dry eye, presence of meibomian gland (MG) dysfunction has been reported in as many as 78% of patients. Clinically, we do not know how early MG architecture may begin to change. The purpose of our study was to determine the preva- lence of MG atrophy in a pediatric population, as earlier detection may prevent later disease. Methods: A total of 98 eyes from 49 participants (23 females) ages 4–17 years (median 10.5 years) were recruited from the Duke Eye Cen- ter. For each patient, meibography was performed using non-invasive LipiView II dynamic meibomian gland imaging software (TearScience, Morrisville, North Carolina), and the Standard Patient Evaluation of Dryness (SPEED) questionnaire was used to record dry eye symptoms. Grading of images was then as- sessed by an experienced rater using the 5-point Meiboscale for gland atrophy, with a grade of 0 indicat- ing normal glands, grade 1 ≤25% atrophy, grade 2 showing 26–50% Best of ASCRS: John Hovanesian, MD, highlighted the best cornea papers at the "Best of ASCRS" session at the 2017 ASCRS•ASOA Symposium & Congress. The papers were chosen from the Best Paper of Session winners. Here are the abstracts from the studies, with Dr. Hovanesian's comments regarding each selection. Eric Donnenfeld, MD, and Ronald Yeoh, MD, moderated the session, with panelists Reay Brown, MD, Clara Chan, MD, Boris Malyugin, MD, Kevin Miller, MD, and Vance Thompson, MD. High-resolution OCT imaging of Bowman layer in asymmetric keratoconus Roshan T, MD, Urvija Choudhary, MS, Rohit Shetty, DNB, Abhijit Roy, PhD, Natasha Pahuja, DOMS, Rushad Shroff, MD Purpose: To assess if irregularity of Bowman's layer is altered in asym- metric keratoconus. Methods: We defined a new index called the Bowman's roughness index (BRI) to assess the irregularity of Bowman's layer in asymmetric keratoconus (KC) using high reso- lution optical coherence tomogra- phy (OCT). Central 3 mm cornea was imaged with OCT. 28 KC eyes, of which 18 had tomographically normal fellow eyes, were imaged, and 26 normal eyes with no clinical signs of KC were imaged. These were also imaged with Pentacam (Oculus, Arlington, Washington). Other indi- ces assessed included Berlin-Ambro- sio enhanced ectasia display overall deviation index (BAD-D), keratoco- nus percentage index (KISA), and cone location magnitude index (CLMI). Results: Mean BRI was 0.00212, 0.00181, and 0.0017 mm 2 in nor- mal, fellow, and KC eyes, respective- ly (p<0.001). BAD-D and BRI had the best sensitivity and specificity to detect fellow normal eyes. By com- bining BAD-D and BRI in a statistical model, sensitivity and specificity improved to 80% and 89.3%, respec- tively. For KC eyes, BRI didn't result in any additional improvement in detection. Conclusion: BRI was lower in the fellow eye, which may indicate that the normal fellow eye may be in ear-

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