Prevalence and Clinical Characteristics of Charles Bonnet Syndrome in Madrid, Spain

Abstract

Purpose Charles Bonnet syndrome (CBS) is a condition characterized by development of visual hallucinations in patients with no cognitive impairment and significant loss of vision mainly caused by age-related macular degeneration (AMD) or glaucoma. Methods This was a study of prevalence and characteristics of CBS diagnosed at the Neuroophthalmic Unit within the Ophthalmology Department of Hospital Clínico San Carlos (HCSC), Madrid, Spain. Results The CBS prevalence in patients from HCSC Madrid is 0.47%, rising to 15% in patients with low vision. Women over 80 years of age comprised 58.3% of the patients, who mainly had AMD (58.3%). Main characteristics of hallucinations included animals (50%), color (58.3%), moving (75%), 6- to 12-month evolution (50%), three times a day frequency (75%), and 3- to 5-minute duration (50%). Conclusions Charles Bonnet syndrome is a complex process that must be treated jointly by ophthalmologists, neurologists, and psychiatrists in order to ensure accurate diagnosis and adequate management. New studies are needed in order to improve awareness of clinical manifestation of this condition, the incidence of which is underestimated due to patients' fear of being branded mentally ill, as well as physicians' lack of knowledge about CBS.

The Prevalence and Characteristics of Charles Bonnet Syndrome in Turkish Patients with Retinal Disease

“…The most common conditions associated with CBS are AMD, cataract, glaucoma and DR [23,24]. AMD is by far the most commonly reported ocular disease associated with CBS [5,22,25]. In our study, 70.5% of the patients with CBS had AMD, which was comparable with the literature.…”

“…If the Danish group had excluded all patients with a visual acuity of >0.5 on the better-seeing eye, they would have reached a prevalence rate of 12%. In a study from Spain, the prevalence rate of CBS was 0.47% and increased to 15% when limited to patients with low vision [22]. These findings were similar to the Danish study.…”

Visual Hallucinations and Ischemic Stroke: Review of 5 Cases

“…These may be white or coloured, static or animated [4,19]. While some of our patients saw simple shapes, balls, or circles, their other hallucinations were more complex, such as their office or a child.…”

“…While the duration is usually less than 12 months, they may persist for several years [4]. Santos Bueso et al reported complex hallucinations that mainly involved people and faces, with movement and colour; their patient had daily episodes lasting between 3 and 5 min that evolved over 6-12 months [20].…”

“…The prevalence of CBS varies ranges from 0.4% to 15% in patients with impaired vision [4]. The most common cause is senile macular degeneration, and other causes are glaucoma, cataracts, postenucleation, optic neuritis, macular photocoagulation, Leber's hereditary optic neuropathy, macular translocation, central retinal artery occlusion, and arteritic and non-arteritic anterior ischemic optic neuropathy [5][6][7][8].…”