Charles Bonnet Syndrome Adversely Affects Vision-Related Quality of Life in Patients with Glaucoma

Purpose

To investigate the impact of Charles Bonnet syndrome (CBS) on vision-related quality of life (VRQoL) in patients with glaucoma.

Design

Cross-sectional cohort study.

Participants

Twenty-four patients with CBS and 42 matched controls without CBS out of 337 patients with open-angle glaucoma (OAG) with visual field (VF) loss.

Methods

A matching technique was used to identify control patients with similar disease stage, best-corrected visual acuity (BCVA) and age to patients with CBS. Patients’ VRQoL was determined using the National Eye Institute Visual Function Questionnaire 25 (NEI VFQ-25). Rasch-calibrated NEI VFQ-25 scores of the CBS group and the control group were compared. Uni- and multivariable regression analysis was used to evaluate the impact of different factors on VRQoL.

Main Outcome Measures

Vision-related quality of life in patients with glaucoma with CBS and without CBS.

Results

Vision-related quality of life scores were significantly lower in the CBS group than in the control group on both the visual functioning scale with 39 points (95% confidence interval (CI): 30–48) vs. 52 points (95% CI: 46–58) (P = 0.013) and on the socioemotional scale with 45 points (95% CI: 37–53) vs. 58 points (95% CI: 51–65) (P = 0.015). Univariable regression analysis showed that integrated visual field mean deviation (IVF-MD) (r² = 0.334, P < 0.001), BCVA in the better eye (r² = 0.117, P = 0.003), and the presence of CBS (r² = 0.078, P = 0.013) were significantly correlated to VRQoL scores on the visual functioning scale. Integrated visual field mean deviation (r² = 0.281, P < 0.001), age (r² = 0.048, P = 0.042), and the presence of CBS (r² = 0.076, P = 0.015) were significantly correlated to VRQoL scores on the socioemotional scale. Multivariable regression analysis showed that IVF-MD and the presence of CBS accounted for nearly 40% of the VRQoL score on the visual functioning scale (R² = 0.393, P < 0.001) and for 34% of the VRQoL score on the socioemotional scale (R² = 0.339, P < 0.001).

Conclusions

Charles Bonnet syndrome had a significant negative association to VRQoL in patients with glaucoma. Presence of CBS should be considered when evaluating VRQoL in patients with glaucoma. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.