September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Charles Bonnet Syndrome in Participants of the Age-Related Eye Disease Study 2 (AREDS2)
Author Affiliations & Notes
  • Elvira Agron
    National Eye Institute, Bethesda, Maryland, United States
  • Traci E Clemons
    EMMES Corporation, Rockville, Maryland, United States
  • Emily Y Chew
    National Eye Institute, Bethesda, Maryland, United States
  • Footnotes
    Commercial Relationships   Elvira Agron, None; Traci Clemons, None; Emily Chew, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2662. doi:
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      Elvira Agron, Traci E Clemons, Emily Y Chew; Charles Bonnet Syndrome in Participants of the Age-Related Eye Disease Study 2 (AREDS2). Invest. Ophthalmol. Vis. Sci. 2016;57(12):2662. doi:

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Charles Bonnet syndrome has been implicated with age-related macular degeneration (AMD) and poor visual function. We examined its association with visual acuity, night vision, AMD, demographics, medication use and comorbidities in AREDS2 participants.

Methods : At the close-out visit participants were asked if they had Charles Bonnet syndrome or visual hallucinations. It may consist of seeing geometric forms, flowers, shrubs, faces or animals. Medication use was collected at close-out including drugs for: intermittent claudication, peptic ulcers, cholesterol lowering (statins), hypertension, sleep or nervous system, and neuromuscular system. A night vision questionnaire (10-items) was administered to evaluate the difficulty in driving and reading in dim light. Visual acuity and presence of AMD at baseline and close-out were compared among participants with hallucinations and those without. The night vision questions and baseline demographics and comorbidities were also compared. For the analyses, χ2 P-values and t-test or Kruskal-Wallis P-values were obtained for categorical variables and continuous variables, respectively.

Results : At close-out, 252 (6.9%) of 3649 participants reported hallucinations. Participants who experienced hallucinations were more likely to be older (74.3±6.8 years vs 72.5±7.9, P=<.001), have less education (≤high school vs post-graduate, 8.5% vs 5.6%, P=0.03), use acetaminophen (users 10.2% vs non-users 6.6%, P=.01) at baseline, and to use these drugs at close-out: statin (12.2% vs 6.6%, P=.001), anti-hypertensive drugs (10.1% vs 6.6%, P=.02), neuromuscular system (Lyrica) (23.5% vs 6.7%, P=.01), and sleep medication (12.6% vs 6.7%, P=.004). Persons with a history of coronary heart disease (CHD) had a higher rate of hallucinations than those without (9.6% vs 6.7%, P=.05). Presence of AMD was associated with a higher rate of hallucinations (baseline: 10.0% vs 5.3%, P=<.001, close-out: 9.6% vs 3.3%, P=<.001). Poor visual acuity and night vision were highly associated with a higher rate of hallucinations (baseline: 11.6% for 20/40-20/200 vs 5.2% for ≥20/20, P<.001, close-out: 13.9% vs 3.5%, respectively, P=<.001; all 10 items, P<.001).

Conclusions : Participants reporting hallucinations were more likely to have poor visual function associated with late AMD than those not reporting hallucinations. CHD was associated with hallucinations.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.


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