Anterior segment assessment in atrial fibrillation and congestive heart failure: insights from a regional cohort

This study aimed to determine whether cardiovascular conditions, specifically atrial fibrillation (AF) and congestive heart failure (CHF), are associated with detectable alterations in anterior segment morphology via Scheimpflug-based corneal tomography (Pentacam^®, Oculus, Germany).

A total of 120 eyes from 120 participants were included in this cross-sectional study. The subjects were categorized into four groups: AF, CHF, AF + CHF, and age- and sex-matched healthy controls (n = 30 per group). All participants underwent a comprehensive ophthalmic evaluation, including Pentacam imaging. The quantitative analyses included keratometric parameters, corneal pachymetry profiles, anterior chamber metrics, pupil diameter, and indices of corneal surface irregularity.

The groups were comparable in terms of age and sex (p > 0.05). No significant intergroup differences emerged in keratometric values, corneal thickness, or anterior chamber metrics, though astigmatism trended lower in the AF + CHF group. Among the irregularity indices, only the keratoconus index (KI) demonstrated an overall group effect (p = 0.049), but post hoc comparisons failed to confirm significance.

Scheimpflug-based tomography revealed largely preserved anterior segment characteristics in individuals with AF and/or CHF. The minor variation observed in the KI may reflect subtle corneal surface irregularities potentially associated with systemic cardiovascular pathology, highlighting the need for larger, longitudinal studies to clarify these findings.