[Value of systematic screening for depressive symptoms and Charles-Bonnet syndrome in AMD patients]

Age-related macular degeneration (ARMD) is the leading cause of blindness in western countries. Along with decrease in vision, ARMD patients, who are often elderly, carry an increased risk of developing depression and Charles-Bonnet syndrome (CBS). However, these disorders remain under-diagnosed. Detection and treatment could considerably improve their quality of life. The aim of our study is to evaluate the relevance and feasibility of systematic screening for depression and CBS in AMD patients.

Patients with ARMD, who showed up to the ophthalmology department of CHU Brugmann (Brussels, Belgium, Université Libre de Bruxelles) over a 4-week period, were asked to measure their depression score using the Geriatric Depression Scale (GDS-15) and to complete a questionnaire on CBS.

In total, 112 patients were recruited. One hundred and six responded to the GDS-15 score; among them 70 patients (66.04%) suffered from depressive symptoms. A multivariate analysis highlighted three risk factors: decreased vision in the better eye (P=0.023), unilateral impairment (P=0.024) and social isolation (P<0.001). One hundred and twelve patients completed the CBS questionnaire, no new diagnoses were made. Six of the 112 patients (5.7%) knew about CBS.

Screening through the GDS-15 depression score should be performed systematically in all ARMD patients. It is important not to overlook psychosocial factors in those patients. In our study, more than two thirds of patients suffer from unrecognised depressive affects. Early detection and adequate treatment could significantly improve their quality of life and compliance. As far as CBS is concerned, given its low prevalence, objective criteria should be established in order to select the patients who need screening.