To report the sudden onset of reversible Charles Bonnet syndrome precipitated by acute severe anemia.
Methods
The charts of three patients (Usher syndrome, bilateral macular degeneration, and bilateral retinal vein occlusion) with acute Charles Bonnet syndrome in the setting of severe anemia were reviewed.
Results
Anemia resulted from bladder surgery, recto-colitis, and severe urinary tract infection. Hemoglobin ranged from 78 to 86 g/L. Decreased visual acuity and formed visual hallucinations (giants, flowers, animals) were present in all three patients. Rapid reversal of Charles Bonnet syndrome and visual acuity improvement followed blood transfusion.
Conclusions
Acute severe anemia can precipitate Charles Bonnet syndrome, which may be reversible by blood transfusion.
TeunisseR.J., CruysbergJ.R., HoefnagelsW.H., VerbeekA.L., ZitmanF.G.Visual hallucinations in psychologically normal people: Charles Bonnet's syndrome. Lancet1996; 347: 794–7.
3.
TeunisseR.J., CruysbergJ.R., VerbeekA., ZitmanF.G.The Charles Bonnet syndrome: a large prospective study in The Netherlands. Br J Psychiatry1995; 166: 254–7.
4.
MenonG.J., RahmanI., MenonS.J., DuttonG.N.Complex visual hallucinations in the visually impaired: the Charles Bonnet Syndrome. Surv Ophthalmol2003; 48: 58–72.
