The prevalence of Charles-Bonnet syndrome in ophthalmic patients: A systematic review and meta-analysis

Charles Bonnet Syndrome (CBS) involves visually impaired yet mentally healthy individuals experiencing visual hallucinations (VH) while being aware of the hallucinations' unreality. Its prevalence varies across different conditions, with low vision, bilateral vision loss and advanced age being established as risk factors. This meta-analysis aims to comprehensively assess CBS literature with regard to CBS prevalence in ophthalmic patients.

A comprehensive literature search was conducted on June 11th and June 13th 2023, using the databases PubMed/MEDLINE and Web of Science. Data evaluation and extraction was accomplished by two separate authors. Study analysis was performed qualitatively, thereafter quantitatively by a subsequent meta-analysis, including subgroup assessments for variations among demographic and ophthalmic variables.

49 eligible studies were identified, encompassing data from 20 303 patients. The collective prevalence of CBS in literature was determined to be 10.2 % (95 % confidence interval: 7.23 % - 14.1 %). Vision rehabilitation patients suffer most frequently from CBS (24.6 %). Patients with retinal diseases, low vision, and glaucoma suffer from CBS at similar rates. The prevalence of CBS among these cohorts spans from 11.8 % to 17.7 %. Age (p = 0.0013) and sex (p = 0.003) correlated statistically significantly with the prevalence of CBS.

CBS is prevalent among ophthalmic patients with various eye diseases, especially in the presence of low vision. Ophthalmologists should consider that about one in six patients with retinal diseases, glaucoma, or low vision they assessed might experience CBS. Awareness among medical professionals should be increased, as education provides patients with relief.