Reversible Charles Bonnet syndrome secondary to upper lid ptosis

Hashmi, Farzeen Khalid; Ogra, Siddharth; Madge, Simon N.

doi:10.1080/01676830.2019.1648522

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…Bilateral YAG capsulotomies resulted in improved visual acuity and complete resolution of his visual hallucinations. This case report demonstrates the importance 9 Upper eyelid ptosis Kolarova H, Catarino CB, Priglinger C, Klopstock, T. 2019. 10 Leber's hereditary optic neuropathy Kim US.…”

Section: Discussionmentioning

confidence: 65%

<p>Charles Bonnet Syndrome in a Patient with Parkinson’s Disease and Bilateral Posterior Capsule Opacification</p>

Osa¹,

Bowen²,

Whitson³

2020

IMCRJ

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Charles Bonnet syndrome (CBS) is a condition of visual hallucinations or disturbances occurring in patients with visual pathway pathology not due to underlying psychiatric, metabolic, or neurologic disease. A patient with Parkinson's disease experiencing visual hallucinations was evaluated by the ophthalmology service and found to have decreased vision due to bilateral reversible posterior capsular opacification. The patient's hallucinations did not improve on clozapine, a medication requiring careful monitoring due to potentially severe systemic side effects. However, the hallucinations resolved and vision improved after bilateral treatment of the posterior capsular opacification. Clozapine was then discontinued, and the patient was able to resume his previous Parkinson's disease therapy. This case highlights the importance of considering visual pathway pathology as a contributing factor to visual hallucinations, even in patients with previously diagnosed underlying psychiatric, metabolic, or neurologic disease that could additionally be the etiology of the visual disturbances.

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Section: Discussionmentioning

confidence: 65%

<p>Charles Bonnet Syndrome in a Patient with Parkinson’s Disease and Bilateral Posterior Capsule Opacification</p>

Osa¹,

Bowen²,

Whitson³

2020

IMCRJ

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“…Tais atvejais, kai regėjimo sutrikimas yra grįžtamas, CBS simptomai išnyksta ar sumažėja tinkamai koregavus regėjimo sutrikimą sukėlusią priežastį. Yra aprašyta atvejų, kai CBS pasireiškė esant ryškiai viršutinio voko ptozei, o pritaikius chirurginį gydymą, RH visiškai išnyko [20]. Toks pats greitas ir visiškas RH išnykimas aprašomas ir pacientams po kataraktos operacijos [21].…”

Section: šArlio Bonė (Charles Bonnet) Sindromasunclassified

Šarlio Bonė (Charles Bonnet) Sindromas

Kaukėnaitė¹,

Etneris²,

Liutkevičienė³

2021

Health Sciences

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Šarlio Bonė (Charles Bonnet) sindromas (CBS) yra būklė, kurios metu sutrikusio regėjimo žmonės, būdami sveikos psichikos, patiria regos haliucinacijas (RH). Pasitaiko gydytojų, kurie nėra girdėję apie šį sindromą, o juo sergantys pacientai apie patiriamus simptomus nelinkę pranešti sveikatos priežiūros specialistams. Tyrimo tikslas – apžvelgti CBS patogenezę, epidemiologiją, klinikinį pasireiškimą bei diagnostikos ir gydymo galimybes. Mokslinių straipsnių, susijusių su šios literatūros apžvalgos tema, paieška buvo atlikta PubMed (Medline), ScienceDirect, SpringerLink mokslinėse duomenų bazėse. Mechanizmai, lemiantys RH pasireiškimą CBS metu, nėra aiškūs. Remiantis deaferencijos teorija, regėjimo sutrikimo metu aferentiniai impulsai nepasiekia neuronų regimojoje žievėje, todėl padidėja jų jautrumas spontaniniams aktyvumo svyravimams, dėl kurių gali pasireikšti RH. CBS pasireiškia 5,7-18,8 proc. asmenų, turinčių regėjimo sutrikimą. Akių liga, kuria sergant CBS nustatomas dažniausiai, yra amžinė geltonosios dėmės degeneracija (AGDD). Nėra aiškiai nustatytų CBS diagnostinių kriterijų, tačiau jis dažniausiai diagnozuojamas esant regėjimo sutrikimui ir suformuotų RH pasireiškimui, esant visiškam arba daliniam suvokimui, kad matomi vaizdai nėra tikri. Diagnozuojant CBS turėtų būti atmestos kitos priežastys, galinčios sukelti RH. Įrodymais pagrįstų CBS gydymo rekomendacijų nėra, tačiau regėjimo sutrikimą sukėlusios priežasties korekcija ir medikamentinis gydymas gali būti naudingi simptomų mažinimui. Svarbu padėti pacientui suprasti, kad pasireiškianti būklė nėra grėsminga ir tokiu būdu sumažinti patiriamą baimę bei nerimą. Dažniausiai CBS praeina savaime, nesant intervencijų poreikio.

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Morphological structure of the levator muscle in congenital and acquired ptosis of the upper eyelid

Филатова

Izmailova

Kondratieva

et al. 2023

Russian Pediatric Ophthalmology

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AIM: To examine the relationship between the morphological structure of the levator in congenital and acquired ptosis based on dynamometric data and histological research. MATERIAL AND METHODS: Dynamometric and histological examination of the morphological structure of the levator in congenital and acquired ptosis of the upper eyelid was conducted. Twenty-seven fragments obtained during the operation to eliminate blepharoptosis were studied. RESULTS: With congenital ptosis of the upper eyelid, the average values of SS and fatigue were 1.060.39 g and 1.880.89 g, respectively; with acquired ptosis, the average values of SS and fatigue were 1.470.66 g and 2.310.91 g, respectively (p 0.05). All the biopsies were divided into two groups. Group 1 included biopsies of 16 patients with congenital ptosis (n=16), and group 2 included 11 levator fragments with acquired ptosis. Macroscopic examination revealed greater levator fragment lengths in the acquired ptosis group than in the congenital ptosis group: 2.331.32 mm and 1.220.34 mm, respectively (p 0.05). The levator fragments differed in color and had denser elastic consistency in the acquired ptosis group than in the congenital ptosis group. The histological picture in congenital ptosis (n=11) was an overgrowth of the fibrousadipose tissue, and five biopsies showed an overgrowth of fibrous tissue with signs of protein dystrophy. In levator biopsies with acquired ptosis, seven biopsies with aponeurotic ptosis of the upper eyelid were characterized by the overgrowth of fibrousadipose tissue. The first biopsy (myasthenic ptosis of the upper eyelid) demonstrated the predominance of adipose tissue, with scattered bundles of striated muscle fibers and areas of connective tissue with bundles of smooth muscle fibers. In the remaining three biopsies, fragments of adipose tissue with signs of edema and hyperplasia were identified. CONCLUSION: Congenital ptosis is characterized by relatively low strength and rapid fatigue of the upper eyelid levator, higher occurrence of fibrousadipose tissue, and fibrous tissue proliferation. Acquired ptosis is characterized by average strength and fatigue. In the acquired ptosis group, histological data indicate an equal ratio of fibrousadipose and adipose tissue growth. These results can be used in the diagnosis of various forms of ptosis and selection of an effective method for surgical correction for this pathology.

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Reversible Charles Bonnet syndrome secondary to upper lid ptosis

Cited by 3 publications

References 17 publications

<p>Charles Bonnet Syndrome in a Patient with Parkinson’s Disease and Bilateral Posterior Capsule Opacification</p>

<p>Charles Bonnet Syndrome in a Patient with Parkinson’s Disease and Bilateral Posterior Capsule Opacification</p>

Šarlio Bonė (Charles Bonnet) Sindromas

Morphological structure of the levator muscle in congenital and acquired ptosis of the upper eyelid

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