CHARGE syndrome without colobomas: Ophthalmic findings

Am J Med Genet C Semin Med Genet. 2020 Sep;184(3):611-617. doi: 10.1002/ajmg.c.31840. Epub 2020 Sep 10.

Abstract

To report ophthalmic findings of patients without colobomas, and with a clinical and molecular diagnosis of CHARGE Syndrome. Retrospective study of ophthalmic findings in 67 CHARGE patients-clinically confirmed diagnosis with positive CHD7 mutation-seen in the Ophthalmology department of Cincinnati Children's Hospital Medical Center between January 1, 2008 through September 25, 2018. Criteria for inclusion in this study was absence of any form of a coloboma in either eye. In our cohort, all patients had a positive CHD7 mutation, in addition to a clinical diagnosis. 19.4% (13/67) of CHARGE patients did not have a coloboma in either eye. 69.2% (9/13) had strabismus, 76.9% (10/13) had a refractive error that warranted refractive correction, 23.1% (3/13) had amblyopia, 38.5% (5/13) had nasolacrimal duct obstruction, 30.8% (4/13) had dry eye syndrome and exposure keratopathy, 15.4% (2/13) had ptosis, 15.4% (2/13) had blepharitis, 15.4% (2/13) had Cortical Visual Impairment, 7.7% (1/13) of patients had optic nerve drusen, 7.7% (1/13) had Marcus Gunn Jaw Winking, and 7.7% (1/13) with an eyelid nevus. There are numerous ophthalmic findings in individuals with CHARGE Syndrome without colobomas. No study to date has evaluated the ophthalmic findings in CHD7 positive CHARGE patients without colobomas. These findings need to be assessed and treated to ensure optimal vision in the CHARGE patient population. Absence of coloboma does not rule out a diagnosis of CHARGE syndrome, and if there is a clinical suspicion, clinical confirmation then genetic testing would be warranted.

Keywords: CHARGE; CHD7; coloboma; ophthalmic findings.

MeSH terms

  • Adolescent
  • Blepharoptosis / complications
  • Blepharoptosis / genetics*
  • Blepharoptosis / pathology
  • CHARGE Syndrome / complications
  • CHARGE Syndrome / genetics*
  • CHARGE Syndrome / pathology
  • Child
  • Child, Preschool
  • Coloboma / complications
  • Coloboma / genetics*
  • Coloboma / pathology
  • DNA Helicases / genetics
  • DNA-Binding Proteins / genetics
  • Female
  • Heart Defects, Congenital / complications
  • Heart Defects, Congenital / genetics*
  • Heart Defects, Congenital / pathology
  • Humans
  • Infant
  • Jaw Abnormalities / complications
  • Jaw Abnormalities / genetics*
  • Jaw Abnormalities / pathology
  • Lacrimal Duct Obstruction / complications
  • Lacrimal Duct Obstruction / genetics*
  • Lacrimal Duct Obstruction / pathology
  • Male
  • Mutation / genetics
  • Nasolacrimal Duct / metabolism
  • Nasolacrimal Duct / pathology
  • Nervous System Diseases / complications
  • Nervous System Diseases / genetics*
  • Nervous System Diseases / pathology
  • Optic Nerve / metabolism
  • Optic Nerve / pathology
  • Reflex, Abnormal / genetics*

Substances

  • DNA-Binding Proteins
  • DNA Helicases

Supplementary concepts

  • Marcus Gunn phenomenon