CHARGE Syndrome Associated with Angle Closure despite High Myopia: A Case Report with Structural Suggestion

Saki Dote; Shunsuke Nakakura; Hirotaka Tanabe; Etsuko Terao; Yuki Nagata; Hitoshi Tabuchi; Yoshiaki Kiuchi

doi:10.1159/000505389

CHARGE Syndrome Associated with Angle Closure despite High Myopia: A Case Report with Structural Suggestion

Case Rep Ophthalmol. 2020 Jan 9;11(1):28-36. doi: 10.1159/000505389. eCollection 2020 Jan-Apr.

Authors

Saki Dote¹, Shunsuke Nakakura¹, Hirotaka Tanabe¹, Etsuko Terao¹, Yuki Nagata¹, Hitoshi Tabuchi¹, Yoshiaki Kiuchi²

Affiliations

¹ Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan.
² Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.

Abstract

CHARGE syndrome is associated with multiple malformations, and the main ocular abnormality is coloboma. We describe an unusual case of a 15-year-old girl with CHARGE syndrome having high intraocular pressure and narrow angle closure despite refractive high myopia (-9.0 dpt) in her left eye. Gonioscopy revealed peripheral anterior synechia (approximately 90°) in the superior quadrant of the left eye. Both eyes exhibited similar axial length (about 22 mm) and corneal curvature (about 8 mm). However, microcornea (9 mm), thicker central cornea and iris induced narrower anterior components in the left eye than in the right eye. Preventing the chance of acute primary angle closure attack, the patient underwent laser iridotomy in the left eye; however, long-term follow-up is needed. Additionally, we developed a hypothesis for the mechanism of unilateral angle closure despite high myopia by investigating the ocular structural parameters in detail.

Keywords: Angle closure glaucoma; CHARGE syndrome; High myopia; Microcornea.

Publication types

Case Reports