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Park and Jeong: The Prevalence and Clinical Characteristics of Charles Bonnet Syndrome in the Republic of Korea
Original Article

Journal of the Korean Ophthalmological Society 2019; 60(12): 1223-1230.

Published online: 17 December 2019

DOI: https://doi.org/10.3341/jkos.2019.60.12.1223

The Prevalence and Clinical Characteristics of Charles Bonnet Syndrome in the Republic of Korea

Young Myoung Park, MD1, Jin Gu Jeong, MD1, 2, 3

1Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea.

2Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea.

3Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Korea.

Address reprint requests to Jin Gu Jeong, MD. Department of Ophthalmology, Chonbuk National University Hospital, #20 Geonji-ro, Deokjin-gu, Jeonju 54907, Korea. Tel: 82-63-250-1965, Fax: 82-63-250-1960, terathan@naver.com

Received 9 August 2019       Revised 6 September 2019       Accepted 29 November 2019

©2019 The Korean Ophthalmological Society

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report the clinical characteristics and prevalence of Charles Bonnet syndrome (CBS) in patients with retinal diseases in the Republic of Korea.

Methods

Patients with deterioration of visual acuity or visual field or episodes of complex visual hallucination (cVH) with retinal diseases between March 2019 and June 2019 at the retinal outpatient clinic of the Chonbuk National University Hospital were selected to answer standardized questions to determine whether they had symptoms of CBS.

Results

The selected 303 patients from the total of 2,916 patients were comprised of 163 males (53.8%) and 140 females (46.2%). The mean age of the patients was 66.0 ± 15.1 years. six patients (2.4%) of 245 with no response to initial question in 301 with best-corrected visual acuity less than finger counting and two patients with experience of cVH were diagnosed with CBS. Most patients had seen a wide variety of hallucinations, including objects, people, and scenery, with negative emotions, for > 1 year. The hallucinations were experienced daily with the same frequency. Negative feelings such as fear and worry improved when they received appropriate patient education about the hallucinations.

Conclusions

The prevalence of CBS in the Republic of Korea is higher than previously reported. We found that relatively young patients with visual impairment could experience cVH from CBS. CBS patients experienced negative emotions for long periods due to the hallucinations which decreased their quality of life. CBS should be considered during the differential diagnosis of cVH in patients with visual impairment due to ophthalmic diseases. We should also provide appropriate patient education to assist them in understanding more fully the clinical characteristics of CBS.

Keywords: Charles Bonnet syndrome, Complex visual hallucination, Negative emotion, Prevalence

Figures and Tables

Figure 1

Characteristics of selected group (n = 303) to ask standardized questions. (A) Age and gender distribution. (B) Ophthalmic diagnoses. MH = macular hole; ERM = epiretinal membrane; RAO = retinal artery occlusion; ME = macular edema; CD = choroidal detachment; PVR = proliferative vitreoretinopathy; ON = optic neuropathy.

jkos-60-1223-g001
Table 1

Design and flow of this prospective study

jkos-60-1223-i001

*Best corrected visual acuity; †dementia, Parkinson disease, Alzheimer disease, Creutzfeldt-Jakob disease etc.

Table 2

Characteristics of patients of Charles Bonnet syndrome

jkos-60-1223-i002

R = right; NLP = no light perception; L = left; FC = finger counting; HM = macular hole; B = both; RP = retinitis pigmentosa; NPDR = non proliferative diabetic retinopathy; ERM = epiretinal membrane; ARMD = age-related macular degeneration; CRVO = central retinal vein occlusion; PXG = pseudoexfoliation glaucoma; N/S = non-specific.

*Visual acuity on the most recent visit.

Notes

Conflicts of Interest The authors have no conflicts to disclose.

Appendix

Appendix 1

Initial question and questions on hallucinations.

jkos-60-1223-a001

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