Abstract
Purpose :
To understand the prevalence, epidemiology and characteristics of CBS in patients with vitreoretinal(VR) and inherited retinal disease(IRD)
Methods :
Single-centre prospective cohort study at the Oxford Eye Hospital. Patients attending retinal genetics and a VR clinicbetween July 2022 to May 2023 were screened verbally for CBS symptoms. Screen-positive patients were invited to complete QR-SCB Questionnaire in clinic to confirm the diagnosis and explore: characteristics of hallucinations, coping strategies, context of appearance of hallucinations, psychological impact and social support. Data on presenting best-corrected visual acuity(BCVA) and diagnosis were collated from hospital records.
Results :
340 patients were screened for CBS and 7.4% (n=25/340) reported experiencing visual hallucinations. Nine patients(mean age 74.2 ± 9.9 years, range 58-92 years; 67% males) have completed the QR-SCB questionnaire thus far; two had IRD and seven patients had VR pathology.
Most patients (n=8/9) experienced more than one form of hallucination and reported seeing points, spots, pulsing lights, animals, and trees. 78%(n=7/9) described the images as more vivid than their normal visual perception, and 57% (n=4/7) stated that images felt real.
Most patients (89%, n=8/9) were symptomatic for over sixmonths. Two people reported CBS symptoms prior to noticingvision problems, while seven developed hallucinationsconcurrent with or after their vision problems. Visual hallucinations typically lasted seconds to minutes, with onepatient describing continuous hallucinations.
All patients reported that the images developed spontaneously; typically when they were alone, feeling relaxed and in a calm environment. 55.6% (n=5/9) described images as being either menacing or worrying and occurring at least once weekly. Only one patient was familiar with CBS.
Conclusions :
CBS can occur regardless of age or pathology and not necessarily in older age as previously thought. The complexity and diversity of visual hallucinations tends to increase with age. In our opportunistic sample, we have shown a 7.4% prevalence of CBS in patients with IRD and VR pathology. Thus,CBS is underdiagnosed in these patients, which can be ameliorated by the aid of a simple screening question. Opportunistic screening of patients in clinic may help facilitate accurate diagnosis and timely support.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.