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Ophthalmic Res. 2020 Jan 27. doi: 10.1159/000506137. [Epub ahead of print]

CLINICAL CHARACTERISTICS OF THE CHARLES BONNET SYNDROME IN PATIENTS WITH NEOVASCULAR-AGE RELATED MACULAR DEGENERATION: THE IMPORTANCE OF EARLY DETECTION.

Abstract

PURPOSE:

We investigated the characteristics, prognosis and clinical outcome of the Charles Bonnet Syndrome (CBS) in patients with neovascular age-related macular degeneration (AMD).

METHODS:

Five hundred patients with neovascular AMD were screened for CBS. Psychiatrically healthy the inclusion criteria individuals that fit the inclusion criteria were systematically interviewed using a structured questionnaire that covered the impact, prognosis, risk factors, phenomenology, impact, prognosis, symptoms report and knowledge about the syndrome. A control group of 45 patients was used for comparison. Demographic data, current medication and ocular risk factors were collected in all patients.

RESULTS:

Forty-five patients with CBS were identified. The majority of patients reported images that consisted of colored (62%) animals (44%) or faces (42%) that lasted for seconds (53%). Most patients reported a self-limited disease with a median duration of symptoms between 9 to 11.5 months with only 7% knowing about CBS at symptom onset. The degree of visual deficit did not predict the characteristics, complexity, frequency, duration and impact of visual hallucinations. A third of patients reported negative outcome, which was associated with shorter duration of CBS (p=0.023), fear-inducing images (p < 0.001) and impact on daily activities (p = 0.015).

CONCLUSION:

The prevalence of CBS in neovascular-AMD patients is high and clinically relevant. Patients with recent onset of visual hallucinations and describing fear-inducing images are at greater risk for negative outcome. Periodic screening may minimize the negative consequences of this disease.

PMID:
31986513
DOI:
10.1159/000506137

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