Steven B Leichter, James Johnston, Alan Schubert, Michael Ammerman and Susan Egbert
From a voluntary ophthalmic screening program, involving 1876 people, carried out in Columbus, Georgia, 273 (14.6%) were found to have arcussenilis. 973 (51.9%) of the total population screened, were found to have evidence of a high risk of hypertension, hyperglycemia, or hyperlipidemia, and were invited to participate in further assessments. 623 (64.0%) of these high risk subjects, including all of the patients with arcussenilis, agreed to further testing. 70% of the subjects has abnormal BMI, 64% had abnormal blood pressure, and 64% had evidence of abnormal fasting blood sugar, either by elevated fasting blood sugar or Hgb A1c > 6%. A minority had abnormality of LDL cholesterol, HDL cholesterol, or fasting serum triglycerides. Comparisons were then made between the 273 patients who had arcussenilis versus the 350 patients, who did not. Patients, who had arcussenilis has lower BMI values (32.6 ± 0.4 vs. 34.6 ± 0.4 kg/m2, p=0.005) and higher fasting blood sugar (133.6 ± 3.6 vs. 125.7 ± 2.3 mg/ dl, p=0.0488) than those who did not have arcus. By multi-variate analysis, increasing age (p<001), fasting blood sugar (p<0.004), Hgb A1c (p<0.01), systolic (p<0.007) and diastolic (p=0.02) blood pressure, and decreasing BMI (p=0.012) were associated with increasing prevalence of arcussenilis. Fasting LDL cholesterol, HDL cholesterol, LDL/HDL ratios, or serum triglycerides showed no association with the prevalence of arcus. We conclude that hyperglycemia and hypertension, but not hyperlipidemia, are the primary metabolic characteristics associated with the occurrence of arcussenilis, and age appears to have a significant association with the occurrence of arcus. These observations suggest that older individuals, who are found they have arcussenilis, should be screened for evidence of hyperglycemia.