Rocky Mountain Neurology, Lone Tree, Colorado, USA.
Department of Ophthalmology.
Curr Opin Ophthalmol. 2020 Nov;31(6):475-482. doi: 10.1097/ICU.0000000000000701.
Recent studies have increased our understanding of the biochemical and structural bases of visual hallucinations in patients with a variety of underlying causes.
Visual hallucinations may be related to disruption of functional connectivity networks, with underlying biochemical dysfunction such as decreased in cholinergic activity. Structural abnormalities in primary and higher order visual processing areas also have been found in patients with visual hallucinations. The occurrence of visual hallucinations after vision loss, the Charles Bonnet syndrome, may have more functional similarity to psychiatric and neurodegenerative causes than previously suspected despite retained insight into the unreal nature of the phenomena.
Visual hallucinations are common, and patients may not report them if specific inquiries are not made. Presence or absence of hallucinations may be of diagnostic and therapeutic importance, especially in patients with neurodegenerative conditions that have overlapping features. Treatment of visual hallucinations remains challenging and must be tailored to each patient based on the underlying cause and comorbid conditions.
最近的研究增加了我们对各种潜在病因患者视觉幻觉的生化和结构基础的理解。
视觉幻觉可能与功能连接网络的中断有关，潜在的生化功能障碍如胆碱能活性降低。在有视觉幻觉的患者中，初级和高级视觉处理区域也发现了结构异常。视力丧失后发生的视觉幻觉，即 Charles Bonnet 综合征，尽管对现象的不真实性质仍有洞察力，但与以前怀疑的情况相比，与精神和神经退行性病因的功能相似性可能更多。
视觉幻觉很常见，如果没有进行特定的询问，患者可能不会报告这些幻觉。幻觉的存在与否可能具有诊断和治疗意义，特别是对于具有重叠特征的神经退行性疾病患者。视觉幻觉的治疗仍然具有挑战性，必须根据潜在病因和合并症为每个患者量身定制。
