title: Leopard spot retinal pigmentation in infancy indicating a peroxisomal disorder.
abstract: BACKGROUND
  Neonatal adrenoleucodystrophy (NALD) is a rare disorder resulting from abnormal peroxisomal biogenesis. Affected patients present in infancy with developmental delay, hypotonia, and seizures. Blindness and nystagmus are prominent features. The authors suggest a characteristic leopard spot pigmentary pattern in the peripheral retina to be diagnostic.
  
  
  METHODS
  Three patients are reported with this presentation; the characteristic retinal appearance resulted in early diagnosis for one of these.
  
  
  CONCLUSIONS
  Leopard spot retinopathy in an infant with hypotonia, seizures, developmental delay, with or without dysmorphic features and hearing impairment, is a clue to the diagnosis of NALD.
authors.affiliation: Department of Ophthalmology, A136 British Columbia Children's Hospital, 4480 Oak Street, Vancouver, BC, Canada V6H 3V4. cjlyons@telus.net
authors.forename: C J
authors.initials: CJ
authors.lastname: Lyons
authors.forename: G
authors.initials: G
authors.lastname: Castano
authors.forename: A Q
authors.initials: AQ
authors.lastname: McCormick
authors.forename: D
authors.initials: D
authors.lastname: Applegarth
mesh_terms: D002658:Developmental Disabilities / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009123:Muscle Hypotonia / Q000209:etiology; D018901:Peroxisomal Disorders / Q000150:complications* / Q000175:diagnosis; D010859:Pigmentation Disorders / Q000209:etiology* / Q000473:pathology; D012164:Retinal Diseases / Q000209:etiology* / Q000473:pathology; D012640:Seizures / Q000209:etiology