Department of Ophthalmology, Skåne University Hospital, Malmö, Sweden; Department of Clinical Sciences Malmö, Ophthalmology, Lund University, Malmö, Sweden.
Department of Ophthalmology, Skåne University Hospital, Malmö, Sweden.
Ophthalmol Glaucoma. 2022 May-Jun;5(3):337-344. doi: 10.1016/j.ogla.2021.10.010. Epub 2021 Oct 21.
To determine the prevalence and characteristics of Charles Bonnet Syndrome (CBS) and its relation to visual field loss (VFL) in patients with open-angle glaucoma (OAG).
Prospective, cross-sectional study.
Adult patients (n = 337) with manifest OAG with verified VFL and without significant macular disease or extraocular conditions known to cause visual hallucinations.
Patients attending the glaucoma outpatient department of the Skåne University hospital, Malmö, Sweden, between April 1, 2018, and December 31, 2018, were consecutively evaluated for inclusion. Potentially eligible patients admitting to having complex visual hallucinations were interviewed to explore the characteristics of their hallucinatory experiences. Recent automated visual field examinations were available for all participants, and swept-source OCT was performed in participants with CBS to rule out previously undiagnosed macular pathology. The correlation between potential risk factors and CBS was evaluated with logistic regression analysis.
Prevalence of CBS in patients with OAG.
Charles Bonnet Syndrome was found in 7.1% (95% confidence interval [CI], 4.7-10.6) of patients with OAG. Participants with CBS were more likely to have at least 1 eye with a visual field index (VFI) of ≤30% compared with those without CBS (71% vs. 34.2%; P = 0.001). Although the best-corrected visual acuity (BCVA) in the worse eye was significantly lower in participants with CBS (decimal equivalent of Snellen BCVA: 0.25 vs. 0.6, P = 0.003), 33% of these participants had a BCVA of ≥0.5 in the worse eye. In multivariable analysis, CBS was correlated to the VFI of the better eye (odds ratio, 0.984; 95% CI, 0.969-0.998, P = 0.030) and the BCVA of the worse-seeing eye (odds ratio, 0.210; 95% CI, 0.046-0.952, P = 0.043).
Charles Bonnet Syndrome was not a rare condition in patients with glaucoma. Patients with a combination of advanced VFL and low BCVA had the highest risk of CBS; however, 1 of 3 patients with CBS had a BCVA of ≥0.5 in both eyes. These findings emphasize the importance of being attentive to symptoms of CBS in patients with glaucomatous VFL even when visual acuity is preserved.
确定开角型青光眼（OAG）患者中 Charles Bonnet 综合征（CBS）的患病率和特征及其与视野缺损（VFL）的关系。
前瞻性、横断面研究。
患有明确的 OAG 且经证实存在 VFL 的成年患者，且无明显的黄斑疾病或已知会引起视觉幻觉的眼外疾病。
2018 年 4 月 1 日至 2018 年 12 月 31 日期间，连续评估瑞典马尔默斯科讷大学医院青光眼门诊的患者是否符合纳入标准。对可能符合条件的患者进行访谈，以了解其幻觉特征，这些患者承认有复杂的视觉幻觉。所有参与者都可获得最近的自动视野检查结果，而在有 CBS 的患者中进行扫频源光学相干断层扫描（OCT）以排除以前未诊断的黄斑病变。采用逻辑回归分析评估潜在危险因素与 CBS 之间的相关性。
OAG 患者中 CBS 的患病率。
OAG 患者中发现 CBS 占 7.1%（95%置信区间[CI]，4.7%-10.6%）。与无 CBS 的患者相比，CBS 患者更有可能存在至少 1 只眼的视野指数（VFI）≤30%（71% vs. 34.2%；P=0.001）。尽管 CBS 患者较差眼的最佳矫正视力（BCVA）明显较低（十进制 Snellen BCVA：0.25 与 0.6，P=0.003），但这些患者中有 33%的较差眼的 BCVA≥0.5。在多变量分析中，CBS 与较好眼的 VFI（优势比，0.984；95%CI，0.969-0.998，P=0.030）和较差眼的 BCVA（优势比，0.210；95%CI，0.046-0.952，P=0.043）相关。
在青光眼患者中，CBS 并非罕见情况。患有晚期 VFL 且 BCVA 较低的患者患 CBS 的风险最高；但是，3 名 CBS 患者中有 1 名在双眼中均有≥0.5 的 BCVA。这些发现强调了即使视力正常，在患有青光眼 VFL 的患者中，也应注意 CBS 的症状。
