title: Corneal arcus is a sign of cardiovascular disease, even in low-risk persons.
abstract: OBJECTIVE
  To examine the association of corneal arcus to cardiovascular disease (CVD) in an adult, ethnic Indian population.
  
  
  METHODS
  Population-based cross-sectional study.
  
  
  METHODS
  Population-based study of ethnic South Asian Indians 40 to 80 years of age in Singapore from June 2007 through March 2009. We obtained a 75.5% response rate (3397/4497). All participants underwent standardized interview and systemic and ocular examinations, followed by nonfasting blood sampling. Corneal arcus was detected using a standardized slit-lamp examination. The main outcome measure was CVD, defined from a self-reported history of previous myocardial infarction, angina, or stroke.
  
  
  RESULTS
  Corneal arcus, found in 1701 (50.1%) of 3397 participants, was associated with older age (odds ratio [OR], 3.07; 95% CI, 2.78 to 3.40; P < .001), male gender (OR, 2.17; 95% CI, 1.81 to 2.62; P < .001), higher levels of total cholesterol (OR, 1.14; 95% CI, 1.05 to 1.24; P = .002), hypertension (OR, 1.14; 95% CI, 1.05 to 1.24; P = .013), and cigarette smoking (OR, 1.59; 95% CI, 1.25 to 2.03; P < .001). Corneal arcus was associated with CVD (OR, 1.31; 95% CI, 1.02 to 1.7; P = .0038) independent of the above-named cardiovascular risk factors. Participants with low-risk Framingham scores were more likely to be associated with CVD if they had corneal arcus (men: OR, 2.02; 95% CI, 1.20 to 3.40; P = .008; women: OR, 2.78; 95% CI, 1.36 to 3.01; P < .001). Corneal arcus was associated with CVD independent of the Framingham score (men: Akaike information criterion, 1524.39 for Framingham Score and corneal arcus vs 1527.38 for Framingham Score alone; women: 1000.14 vs 1003.54, respectively).
  
  
  CONCLUSIONS
  Corneal arcus is associated with CVD, independent of risk factors in ethnic Indian adults, even in those at low risk for vascular disease.
authors: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore.
authors: Marcus
authors: M
authors: Ang
authors: Wanling
authors: W
authors: Wong
authors: Judy
authors: J
authors: Park
authors: Renyi
authors: R
authors: Wu
authors: Raghavan
authors: R
authors: Lavanya
authors: Yingfeng
authors: Y
authors: Zheng
authors: Howard
authors: H
authors: Cajucom-Uy
authors: E Shyong
authors: ES
authors: Tai
authors: Tien Yin
authors: TY
authors: Wong
mesh_terms: D001112:Arcus Senilis / Q000097:blood / Q000175:diagnosis* / Q000208:ethnology; D044466:Asian People / Q000208:ethnology; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis* / Q000208:ethnology; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007194:India / Q000208:ethnology; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose; D002784:Cholesterol; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human