J Korean Ophthalmol Soc.  2019 Dec;60(12):1223-1230. 10.3341/jkos.2019.60.12.1223.

The Prevalence and Clinical Characteristics of Charles Bonnet Syndrome in the Republic of Korea

• Park YM
• Jeong JG

• KMID: 2466174
• DOI: http://doi.org/10.3341/jkos.2019.60.12.1223

Abstract

PURPOSE
To report the clinical characteristics and prevalence of Charles Bonnet syndrome (CBS) in patients with retinal diseases in the Republic of Korea.
METHODS
Patients with deterioration of visual acuity or visual field or episodes of complex visual hallucination (cVH) with retinal diseases between March 2019 and June 2019 at the retinal outpatient clinic of the Chonbuk National University Hospital were selected to answer standardized questions to determine whether they had symptoms of CBS.
RESULTS
The selected 303 patients from the total of 2,916 patients were comprised of 163 males (53.8%) and 140 females (46.2%). The mean age of the patients was 66.0 ± 15.1 years. six patients (2.4%) of 245 with no response to initial question in 301 with best-corrected visual acuity less than finger counting and two patients with experience of cVH were diagnosed with CBS. Most patients had seen a wide variety of hallucinations, including objects, people, and scenery, with negative emotions, for > 1 year. The hallucinations were experienced daily with the same frequency. Negative feelings such as fear and worry improved when they received appropriate patient education about the hallucinations.
CONCLUSIONS
The prevalence of CBS in the Republic of Korea is higher than previously reported. We found that relatively young patients with visual impairment could experience cVH from CBS. CBS patients experienced negative emotions for long periods due to the hallucinations which decreased their quality of life. CBS should be considered during the differential diagnosis of cVH in patients with visual impairment due to ophthalmic diseases. We should also provide appropriate patient education to assist them in understanding more fully the clinical characteristics of CBS.

Keyword

Charles Bonnet syndrome; Complex visual hallucination; Negative emotion; Prevalence

MeSH Terms

Ambulatory Care Facilities
Diagnosis, Differential
Female
Fingers
Hallucinations
Humans
Jeollabuk-do
Male
Patient Education as Topic
Prevalence*
Quality of Life
Republic of Korea*
Retinal Diseases
Retinaldehyde
Vision Disorders
Visual Acuity
Visual Fields
Retinaldehyde

Figure

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  Figure 1 Characteristics of selected group (n = 303) to ask standardized questions. (A) Age and gender distribution. (B) Ophthalmic diagnoses. MH = macular hole; ERM = epiretinal membrane; RAO = retinal artery occlusion; ME = macular edema; CD = choroidal detachment; PVR = proliferative vitreoretinopathy; ON = optic neuropathy.

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