Department of Ophthalmology, Rigshospitalet-Glostrup, Glostrup, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Acta Ophthalmol. 2021 Mar;99(2):128-133. doi: 10.1111/aos.14567. Epub 2020 Aug 4.
Glaucoma is a widespread sight-threatening condition often only recognized when very pronounced. It is initially characterized by peripheral visual field losses, while advanced stages also affect the central vision. Some of these patients may experience visual hallucinations, the Charles Bonnet syndrome (CBS). In this systematic review and meta-analysis, we provide an overview of the literature dealing with the prevalence of CBS in patients with glaucoma. We searched the databases PubMed/MEDLINE, Embase, Web of Science, the Cochrane Central and PsycInfo on 22 March 2020. Eight studies (n = 827 patients) were identified and included for a qualitative and quantitative analysis. No studies included a representative sample of patients with only glaucoma. In patients with glaucoma in different stages and with ocular comorbidities, prevalence of CBS was 2.8% (CI95%: 0.7-6.1%). Among patients with glaucoma where all had bilateral low visual acuity, prevalence of CBS was 13.5% (CI95%: 8.4-19.6%). In patients with glaucoma who visited vision rehabilitation clinics, presumably due to an extensive vision impairment, prevalence of CBS was 20.1% (CI95%: 16.8-23.6%). Risk factors of CBS besides low vision were high age, female gender, reduced contrast sensitivity and not living alone. Taken together, we find that CBS may not be rare in patients with advanced glaucoma with and without ocular comorbidities. However, limitations of the current literature should be highlighted and careful approach towards conclusions is important. More studies are needed to better understand the prevalence and risk factors among different populations of patients with glaucoma.
青光眼是一种广泛存在的、可致盲的眼部疾病，通常在疾病非常明显时才被发现。它最初的特征是视野周边损失，而晚期还会影响中心视力。一些此类患者可能会出现幻视，即 Charles Bonnet 综合征（CBS）。在本次系统回顾和荟萃分析中，我们综述了有关青光眼患者 CBS 患病率的文献。我们于 2020 年 3 月 22 日检索了 PubMed/MEDLINE、Embase、Web of Science、Cochrane 中心和 PsycInfo 数据库。确定了 8 项研究（n=827 名患者），并对其进行了定性和定量分析。没有研究纳入仅患有青光眼的患者的代表性样本。在不同阶段的青光眼患者和患有眼部合并症的患者中，CBS 的患病率为 2.8%（95%CI：0.7-6.1%）。在所有双眼视力均低下的青光眼患者中，CBS 的患病率为 13.5%（95%CI：8.4-19.6%）。在因视力严重受损而就诊于视力康复诊所的青光眼患者中，CBS 的患病率为 20.1%（95%CI：16.8-23.6%）。除了低视力之外，CBS 的风险因素还包括高龄、女性、对比敏感度降低和独居。综上，我们发现 CBS 在患有晚期青光眼且伴有或不伴有眼部合并症的患者中可能并不罕见。但是，应该强调当前文献的局限性，对结论的把握应尤为谨慎。需要更多的研究来更好地理解不同青光眼患者群体中的患病率和风险因素。
