CHARGE association with congenital glaucoma due to maldevelopment of the anterior chamber angle

Purpose: We examined the clinicopathologic features of a male infant with the CHARGE association and bilateral congenital glaucoma. Methods: Trabeculectomy specimens were obtained from the anterior chamber angle and examined by light and electron microscopy. Results: Histopathologic examination of the trabeculectomy specimens showed immature development of the trabecular meshwork that was covered by the ciliary muscles. There were few intertrabecular spaces because the meshwork was almost completely filled with cells and extracellular substances. Deposition of a granular and/or homogeneous substance was observed in the subendothelial area of Schlemm's canal. Conclusions: Our patient exhibited features typical of the CHARGE association, but also had congenital glaucoma. We hypothesize that these clinical findings are all mediated by a neurocristopathic mechanism. Our findings suggest that the CHARGE association may predispose to anterior chamber angle maldevelopment, which can lead to congenital glaucoma.