Corneal arcus is a
lipid-rich and predominantly extracellular deposit that forms at the corneoscleral limbus. It represents the most common peripheral
corneal opacity and is not associated with tissue breakdown but rather with the deposition of
lipids. The deposition of
cholesterol in the peripheral cornea and arterial wall are similar in that both are accelerated by elevated serum levels of atherogenic
lipoproteins, such as
low-density lipoproteins (
LDL).
Corneal arcus is more prevalent in men than in women and in Blacks than in Whites. Its prevalence increases with advancing age. It has been associated with
hypercholesterolemia, xanthelasmas, alcohol, blood pressure, cigarette smoking, diabetes, age, and
coronary heart disease. Nevertheless, it is not clear whether or not
corneal arcus is an independent risk factor for
coronary heart disease (CHD). The present systematic review examines the relationship of
corneal arcus and CHD to determine if
corneal arcus is an independent CHD risk factor. We conclude that there is no consensus that
corneal arcus is an independent risk factor. The presence of
corneal arcus in a young person should prompt a search for
lipid abnormalities. Also, because
corneal arcus represents physical evidence of early
lipid deposition, its presence suggests the need for aggressive
lipid therapy.