Corneal arcus: indicator for severity of coronary atherosclerosis?

The occurrence of a corneal arcus before the age of 60 years has been associated with the presence of atherosclerosis and the occurrence of hypercholesterolemia. The aim of this observational study was to assess the correlation between the presence of a corneal arcus and the severity of coronary artery disease.

A consecutive group of 200 Caucasian patients aged 40-60 years were studied. All patients were scheduled for diagnostic coronary angiography in a tertiary referral center.

The severity of coronary disease was assessed by coronary angiography. A corneal arcus was observed in 38% of the patients. The prevalence of multivessel disease on a coronary angiogram was significantly higher in the group of patients with corneal arcus (p < 0.02). Patients with a corneal arcus compared to patients without a corneal arcus were slightly older (p < 0.05). Corrected for age, patients with an arcus has a relative risk for multivessel disease of 3.3 (CI 1.1-12.1, p < 0.05).

In Caucasian patients with symptoms of coronary disease, the presence of a corneal arcus below 60 years of age indicates a high risk for multivessel coronary atherosclerosis.