July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Charles Bonnet Syndrome in Participants of the Age-Related Eye Disease Study 2 (AREDS2) 10-year Follow-on
Author Affiliations & Notes
  • Elvira Agron
    National Eye Institute, Bethesda, Maryland, United States
  • Emily Y Chew
    National Eye Institute, Bethesda, Maryland, United States
  • Tiarnan D L Keenan
    National Eye Institute, Bethesda, Maryland, United States
  • Traci E Clemons
    EMMES Corporation, Rockville, Maryland, United States
  • Footnotes
    Commercial Relationships   Elvira Agron, None; Emily Chew, None; Tiarnan Keenan, None; Traci Clemons, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1173. doi:https://doi.org/
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      Elvira Agron, Emily Y Chew, Tiarnan D L Keenan, Traci E Clemons; Charles Bonnet Syndrome in Participants of the Age-Related Eye Disease Study 2 (AREDS2) 10-year Follow-on. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1173. doi: https://doi.org/.

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

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Abstract

Purpose : To describe the prevalence and characteristics of the Charles Bonnet syndrome (CBS) experienced by participants of the AREDS2 10-year Follow-on (FO) study and evaluate its association with late age-related macular degeneration (AMD) and cataract surgery

Methods : The AREDS2 participants were evaluated for symptoms of CBS at the AREDS2 close-out visit (2012). A subset of participants was followed via telephone every 6 months for 5 more years. During the FO, data on AMD and cataract surgery were collected. Questions dealing with visual hallucinations (VH) associated with CBS were asked: type (geometric shapes, patterns, flower, faces, buildings), frequency and duration. Comparisons of the participants with and without CBS ever were conducted using the χ2 and Wilcoxon rank-sum tests, for categorical and continuous variables, respectively. Multivariate logistic regression was used to assess risk factors for CBS.

Results : During the FO study, 2339 participants responded to the questions regarding CBS. They had been followed for a median of 11 years since baseline. Among them, 238 (10.2%) reported CBS during FO. An additional 101 participants of the 2339 had reported CBS ever at the AREDS2 close-out visit, making the total 339 (14.5%). In unadjusted analyses, participants who reported CBS ever were more likely to be older (73±7 years vs 70±8, P=<.001), have less education (≤high school vs post-graduate studies, 17% vs 11%, P=.02), and use acetaminophen (users 21% vs non-users 14%, P=.01) at baseline. Also, presence of late AMD and cataract surgery ever were associated with a higher rate of CBS (yes vs no: 18% vs 8% and 17% vs 11% respectively, P=<.001). After adjusting for age and sex, late AMD, cataract surgery and acetaminophen use remained significant in the multivariate model (odds ratios: 2.20, 1.30, 1.53, P=<.001, .05, .02). The median duration of seeing VH was 2 years. They occurred daily, weekly or monthly in 28%, 33% and 39% participants. The percentage of participants ever seeing geometric shapes, patterns, flowers, faces and/or buildings were: 40%, 44%, 3%, 50% and 12%, with 45% of the participants seeing more than one type.

Conclusions : Participants with CBS were more likely to have late AMD and cataract surgery than those without CBS. VH were most often seen weekly and monthly. Seeing shapes, patterns and faces were most common.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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