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It is mainly caused by aberrant neural innervation of the extraocular muscles. This study aimed to investigate the genetic characteristics and clinical manifestations of CFEOM1 in Chinese families.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The clinical data, including ocular examinations, magnetic resonance imaging (MRI), and surgical procedures of affected individuals from 16 Chinese CFEOM1 families, were collected. The genomic DNA of 16 probands and their family members were sequenced for causative <jats:italic>KIF21A<\/jats:italic> gene mutations. Linkage analysis using microsatellite markers across <jats:italic>KIF21A<\/jats:italic> was also conducted.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Affected individuals were presented with bilateral non-progressive ptosis, restricted horizontal eye movement, fixed infraduction of both eyes, compensatory chin-up head position, and neuromuscular abnormalities. Three heterozygous <jats:italic>KIF21A<\/jats:italic> mutations, c.2860C\u2009&gt;\u2009T (p.R954W) (in eight families), c.2861G\u2009&gt;\u2009T (p.R954L) (in two families), and c.2861G\u2009&gt;\u2009A (p.R954Q) (in two families) were identified, which implied that hotspot mutations were common in Chinese CFEOM1 families. Germline Mosaicism was likely to be the cause of affected individuals with asymptomatic parents without <jats:italic>KIF21A<\/jats:italic> mutations presented in the eight families. Two affected individuals underwent modified levator muscle complex suspension surgery and achieved a good result without any complications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Instead of evaluating the whole CFEOM1 gene variant, hotspot mutations could be given priority for screening. The occurrence of germline mosaicism has to be taken into account in genetic counseling. Patients with CFEOM1 who have ptosis may benefit from an innovative surgical procedure called modified levator muscle complex suspension.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00417-022-05830-3","type":"journal-article","created":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T03:30:46Z","timestamp":1663903846000},"page":"879-889","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Phenotype, genotype, and management of congenital fibrosis of extraocular muscles type 1 in 16 Chinese families"],"prefix":"10.1007","volume":"261","author":[{"given":"Moxin","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingjie","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deyi Jasmine","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qin","family":"Shu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pengcheng","family":"Xun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping","family":"Gu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8112-7702","authenticated-orcid":false,"given":"Lin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,9,23]]},"reference":[{"issue":"2","key":"5830_CR1","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1038\/s41433-019-0700-z","volume":"34","author":"AJ Vivian","year":"2020","unstructured":"Vivian AJ (2020) Congenital fibrosis of the extra-ocular muscles (CFEOM) and the cranial dysinnervation disorders. 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