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A study of arcus senilis in Caucasian men and women is reported. The prevalence of arcus senilis increases with age in both sexes and occurs more frequently in men. In women arcus senilis is uncommon before the menopause. The occurrence of arcus senilis in Caucasians is not a significant finding, except in men under the age of 40 years, when it is associated with an increased risk of coronary artery disease.
Because of the frequent presence of corneal arcus senilis in patients affected by Dupuytren's disease in order to evaluate this association, the authors conducted a biomicroscopic examination of the cornea in 336 patients treated surgically for Dupuytren's disease, at the Hand Surgery Unit of the University of Modena from November 1985 to December 1989. They observed corneal arcus senilis in 259 patients, i.e. in 77.1% of patients with Dupuytren's disease. Due to the statistically significant correlation between arcus senilis and hyperlipidemia as reported by Tschetter (1980) and Felder (1981), the Authors collected a blood sample from all 336 patients to evaluate serum cholesterol and tryglicerides. This study revealed a dyslipidemia in 54.8% of patients with Dupuytren's disease and in 60.2% of patients suffering from both Dupuytren's disease and arcus senilis. Because of the high frequency of dislipidemia in patients with Dupuytren's disease and arcus senilis, which are apparently two well-distinguished disease, the authors suggest that a lipid disorder may be a common aetiopathogenic factor. In particular, in favour of the possible role of hyperlipidemia in Dupuytren's disease, Electron Microscope Studies revealed lipid inclusions within fibroblasts and in the extracellular connective tissue of all pathologic palmar aponeurosis from 11 patients with Dupuytren's disease: these lipid inclusions were never seen in the normal aponeurosis taken from 5 control patients treated for traumatic palmar injuries.
Corneal arcus senilis has long implied cardiovascular disease because of its association with altered lipid levels. This study demonstrates that arcus senilis does not have a higher prevalence rate in diabetics than non-diabetics in spite of the increased cardiovascular risk in insulin-dependent diabetics.
Arcus senilis is a deposition of lipid at the corneal periphery. It is dependent on vascularity for formation and is not a degenerative change. The prevalence of arcus increases with age, and it appears more in blacks and males. It appears to be related to cardiovascular disease but has not been shown to be a reliable predictor of the disease. We studied the incidence of arcus width with age and found no definite correlation.
The frequency and degree of arcus in relation to a number of attributes or risk factors were tested in 534 male patients of all ages with coronary heart disease. Frequency and degree of arcus were positively associated with age and with lifetime alcohol intake. Arcus was negatively associated with obesity. All other correlations proved negative. The link between precocious arcus senilis and coronary heart disease is discussed. This investigation failed to show any relation between the acknowledged high-grade coronary heart disease risk factors and arcus senilis. It is suggested that the relation between arcus and alcohol intake merits further investigation.
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