Moorfields Eye Hospital NHS Foundation Trust, London, UK.
Institute of Ophthalmology, University College London, London, UK.
Br J Ophthalmol. 2021 Nov;105(11):1604-1609. doi: 10.1136/bjophthalmol-2020-317237. Epub 2020 Sep 15.
BACKGROUND/AIMS: Charles Bonnet syndrome (CBS) is a complication of sight loss affecting all ages; yet, few childhood cases have been reported. Our aim is to raise awareness of this under-reported association occurring in children and young adults in order to prevent psychological harm in this age group.
A retrospective case series reviewing medical notes of patients <25 years of age with sight loss and reported CBS at a single centre hospital eye service in London, United Kingdom. Search of electronic patient records identified 13 patients experiencing hallucinatory events over a 9-year period. Outcomes were patient demographics including ocular diagnosis, visual acuity at time of onset, characteristics of hallucinations, clinical management strategies and patient-reported affliction.
Eight patients were diagnosed with progressive inherited retinal diseases, primarily Stargardt disease (N=5). Clinical history indicated patients had significantly reduced best-corrected visual acuity (BCVA) in at least one eye at onset; median (IQR) worse eye BCVA was 1.0 (0.86-1.6) logarithm of minimum angle of resolution(LogMAR). CBS significantly affected patients' personal lives including education, diet and sleep. Clinical management was varied, mostly relating to reassurance at the point of contact.
We describe the clinical features of young patients with CBS, with management strategies and aspects of negative outcomes. High potential caseload and risk of psychological harm merit further research. Increased awareness among healthcare professionals and patient education to forewarn susceptible individuals may reduce the overall impact and improve coping with symptoms.
背景/目的：Charles Bonnet 综合征（CBS）是一种视力丧失的并发症，影响所有年龄段；然而，很少有儿童病例报道。我们的目的是提高对这种在儿童和青年中报告较少的关联的认识，以防止该年龄段的心理伤害。
回顾性病例系列研究，对在英国伦敦一家单一中心医院眼科服务中心因视力丧失和报告 CBS 的 25 岁以下患者的病历进行回顾。通过电子病历搜索，确定了 9 年内出现幻觉的 13 名患者。结果是患者的人口统计学特征，包括眼部诊断、发病时的最佳矫正视力、幻觉的特征、临床管理策略和患者报告的不适。
8 名患者被诊断为进行性遗传性视网膜疾病，主要为 Stargardt 病（N=5）。临床病史表明，患者在发病时至少一只眼的最佳矫正视力（BCVA）明显下降；中位数（IQR）较差眼 BCVA 为 1.0（0.86-1.6）对数最小角分辨率（LogMAR）。CBS 严重影响了患者的个人生活，包括教育、饮食和睡眠。临床管理各不相同，主要是在接触点提供安慰。
我们描述了年轻 CBS 患者的临床特征、管理策略和负面结果。高潜在病例数和心理伤害风险值得进一步研究。提高医疗保健专业人员和患者的意识，以预先警告易感个体，可能会减轻整体影响，并改善对症状的应对。
