Association between corneal arcus and some of the risk factors for coronary artery disease.

Abstract

SUMMARY The relationships between coronary artery disease risk factors and corneal arcus were examined in 150 adults aged 55 years and above of both sexes and from different ethnic origins. The width of the corneal arcus was measured accurately by a digitiser, and the risk factors for coronary artery disease were examined according to the standard procedure used by the Lipid Research Clinics. The results show that the corneal arcus is more frequent in males; the frequency and size of corneal arcus are positively associated with age; there is a positive correlation between the size of corneal arcus and the levels of cholesterol and low-density lipoprotein in males; and that there is negative correlation between corneal arcus and diastolic blood pressure in both sexes. No associations were found between corneal arcus and other coronary artery disease risk factors such as triglyceride, high-density lipoprotein, very low-density lipoprotein, weight, Quetelet's ratio, glucose, and smoking.Corneal arcus is a common change of the aging cornea. Lipids accumulate at the periphery of the cornea (in the peripheral corneal stroma, Bowman's membrane, and Descemet's membrane) and form a ring-like opacity. A clear zone of about 1 mm remains between the corneal arcus and the limbus; the central part of the cornea is never involved. IThe corneal arcus is clinically harmless. Vision is not diminished, and ulcerations and vascularisation of the cornea do not occur. Corneal arcus is nevertheless interesting because of its occurrence with certain other diseases, such as hyperlipoproteinaemia, especially types II and III.2Several investigators have reported that corneal arcus is more likely to occur in patients with coronary artery disease (CAD) than in healthy controls, especially those under 50 years of age,3 while another7 noted significant correlation between the degree of corneal arcus and the incidence of electrocardiographic abnormalities in elderly patients.

A Population-based Study of Corneal Arcus and its Risk Factors in Iran

“…Few studies have performed work around this relationship. Pe'er and co-workers 23 found no significant difference in visual acuity between arcus and non-arcus groups. Studies examining corneal arcus have mostly concentrated on its importance and role as a marker for cardiovascular disease, and evidently, the degeneration does not impact vision.…”

The association of corneal arcus with coronary heart disease and cardiovascular disease mortality in the Lipid Research Clinics Mortality Follow-up Study.

“…In order to account in analysis for the sampling scheme, the data are treated as a stratified random sample, with two strata: hyperlipidemics, all of whom were invited to Visit 2, and normolipidemics (including borderline hyperlipidemics), 15 …”

“…9 Moreover, it has been found to be related to risk factors of CHD such as hyperlipidemia and to occur more often among patients with familial dyslipoproteinemias. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] However, data from several studies showed no independent relationship between corneal arcus and CHD and suggested that both were related to elevated serum cholesterol levels.7,8,'2,15,17 Segal, et The interviewers were trained to identify corneal arcus in the Visit 2 using a uniform protocol.23,24 They stood in front of the participants so that their eyes were at the same level during the examination, which was usually done in natural (rather than artificial) light, the source of which was tangential to the eye. The upper and lower poles of the eyes were examined.…”

Relation of Corneal Arcus to Cardiovascular Disease (from the Framingham Heart Study Data Set)

“…Arcus formation usually begins on the superior and inferior poles of the cornea and often progresses to form a complete ring without visual impairment. 5 Its formation, although not fully understood, shares some similarities with the atherosclerotic process. 6 Corneal arcus was first suggested as a cardiac risk factor by Virchow in 1852, 7 and has been supported by several, 8–15 but not all 3, 16, 17 subsequent studies.…”