Safe and effective methylphenidate therapy in a pediatric patient with glaucoma

Purpose: The aim of this study was to determine the usefulness of the lamina cribrosa thickness (LCT) and lamina cribrosa depth (LCD) in adolescence with attention-deficit hyperactivity disorder (ADHD) and compare with those receiving methylphenidate (MPH) and healthy controls. Methods: Fifty-five children with ADHD (9.23 ± 1.92 years, mean ± standard deviation), 41 children with ADHD given MPH (9.24 ± 1.84 years), and 86 healthy controls (9.95 ± 2.16 years) were recruited for the study. All subjects were subjected to a complete eye exam and optical coherence tomography (OCT) was used to assess LCT and LCD. The severity of ADHD symptoms was evaluated by using parent-report measures, including Conners’s Parent Rating Scale–Revised: Short Form (CPRS-R: S) and the Strengths and Difficulties Questionnaire: Parent Form (SDQ: P). Results: The study showed a significant finding between the research groups with regard to LCT. LCT was shown to be significantly increased in ADHD subjects given MPH compared with the controls. However, LCD was not significantly different between cohorts. Also, a significant inverse correlation was found between the SDQ: P–Emotional Problems Subscale and LCT ( r = −0.253; P = 0.030) in ADHD patients. Conclusion: Changes in lamina cribrosa (LC) in ADHD children receiving MPH suggest that the mechanism of action for MPH may target developing LC structures. More studies to define the relationship between MPH medications and the LC variations are defensible.

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“…[ 25 ] Nevertheless, this recommendation is only hypothetically based on the potential action of MPH. [ 8 9 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 7 ] However, this recommendation is a precaution that has resulted from the possible action of MPH on IOP progression. [ 8 9 ]…”

mentioning

confidence: 99%

Assessment of the lamina cribrosa in attention-deficit hyperactivity disorder

Akkaya

Ulusoy

Doğan

et al. 2021

Indian Journal of Ophthalmology

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“…20 In contrast, safe use of methylphenidate has been reported in 2 patients who had previously been diagnosed with openangle glaucoma and did not develop increased IOP after starting methylphenidate treatment. 13,21 Topiramate, used in children as an antiepileptic agent, is one of the best-known drugs to be associated with the development of glaucoma. At least 2 pediatric cases of acute myopia and acute angle closure glaucoma that developed after topiramate treatment have been reported.…”

Section: Discussionmentioning

confidence: 99%

The effects of methylphenidate on refraction and anterior segment parameters in children with attention deficit hyperactivity disorder

Larrañaga-Fragoso

Noval

Rivero

et al. 2015

Journal of American Association for Pediatric Ophthalmology and

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“…7 In contrast, safe use of MPH was reported in two patients with glaucoma who did not present with increase in IOP after initiating MPH treatment. 14,15 On the other hand, Soyer et al reported a 9-year-old boy, presented with a significant decrease in visual acuity secondary to accommodation disorder after being treated with MPH, 40 mg/day. 8 Two cases of ATX-related mydriasis have also been reported.…”

Section: Findings and Comparisons With Similar Studiesmentioning

confidence: 99%

The effects of medication on intraocular pressure in children with attention deficit hyperactivity disorder: A prospective study

Guvenmez

Çubuk²,

Güneş³

2020

jptcp

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Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric conditions in childhood. Psychopharmacological therapy is an effective treatment for ADHD. In this study, we primarily aim to investigate the effects of psychopharmacological agents on intraocular pressure (IOP) in children with ADHD. The sample included 82 children with ADHD and 36 healthy children aged between 8 and 12 years who were referred to the Department of Child and Adolescent Psychiatry in Hatay State Hospital, Hatay, Turkey. Children with ADHD were divided into two groups according to the medication used: methylphenidate (MPH) group and atomoxetine (ATX) group. Before treatment and after 1-and 6-month treatment period, IOP was measured by Goldmann applanation tonometry. There were no statistical differences in terms of age, gender, and IOP between the three groups (P > 0.05). After 1-and 6-month treatment, the IOP did not change significantly between baseline and 1 month or 6 months (P > 0.05). Children with ADHD may have an IOP similar to healthy children. Six-month treatment with MPH or ATX may not cause significant changes in IOP.

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Safe and effective methylphenidate therapy in a pediatric patient with glaucoma

Cited by 5 publications

References 9 publications

Assessment of the lamina cribrosa in attention-deficit hyperactivity disorder

Assessment of the lamina cribrosa in attention-deficit hyperactivity disorder

The effects of methylphenidate on refraction and anterior segment parameters in children with attention deficit hyperactivity disorder

The effects of medication on intraocular pressure in children with attention deficit hyperactivity disorder: A prospective study

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