title: Increasing exotropia and decreasing vision in a school-aged boy.
abstract: An 8-year-old boy presented with bilateral visual loss and an increasing exotropia, and later developed deteriorating school performance. Magnetic resonance imaging of the head showed bilateral, symmetric, T2, and FLAIR white matter abnormalities in the parieto-occipital regions. Elevated serum very long chain fatty acids confirmed the diagnosis of X-linked adrenoleukodystrophy. Ophthalmologists should be aware of the diagnosis in boys with visual loss, hyperactivity, behavioral changes, and deterioration in school performance. Visual loss may be the presenting or predominant feature in X-linked adrenoleukodystrophy.
authors.affiliation: Department of Ophthalmology at the University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Lee
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Olson
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Bonthius
authors.forename: Paul H
authors.initials: PH
authors.lastname: Phillips
mesh_terms: D000326:Adrenoleukodystrophy / Q000150:complications* / Q000175:diagnosis; D002648:Child; D003937:Diagnosis, Differential; D005099:Exotropia / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D015354:Vision, Low / Q000175:diagnosis / Q000209:etiology*; D014792:Visual Acuity