The association between attention-deficit/hyperactivity disorder and retinal nerve fiber/ganglion cell layer thickness measured by optical coherence tomography: a systematic review and meta-analysis

Li, Sophia Ling; Kam, Ka Wai; Chee, Arnold Shau Hei; Zhang, Xiu Juan; Chen, Li Jia; Yip, Wilson W K; Tham, Clement C.; Young, Alvin L.; Wong, Ian Chi Kei; Ip, Patrick; Yam, Jason C.

doi:10.1007/s10792-021-01852-8

Cited by 12 publications

(5 citation statements)

References 24 publications

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“…Thus, we expected to find an association between ADHD and anatomic structural abnormalities of the eye and the retina, but we did not. Contrary to Li et al [ 19 ] we found no differences between ADHD and controls on retinal fiber layer thickness; our finding, however, emerged from a larger pool of studies.…”

Section: Discussioncontrasting

confidence: 99%

“…There is meta-analytic evidence of structural abnormalities of the eye itself in ADHD, together with altered oculomotor control. Li et al [ 19 ] found reduced retinal nerve fiber layer (RNFL) in people with ADHD; however, their systematic search resulted in only four eligible studies to be included in the meta-analyses. Maron et al [ 20 ] recently confirmed the presence of oculomotor disturbances in people with ADHD compared to neurotypical individuals, especially for saccade inhibition and control, and visuo-spatial memory; considering that their systematic review and meta-analysis was published in 2021, we decided to not include, in our study, any study investigating eye movements in ADHD.…”

Section: Introductionmentioning

confidence: 99%

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Association between ADHD and vision problems. A systematic review and meta-analysis

et al. 2022

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Aim To conduct the first systematic review and meta-analysis assessing whether attention-deficit/hyperactivity disorder (ADHD) is associated with disorders of the eye, and/or altered measures of visual function. Method Based on a pre-registered protocol (PROSPERO: CRD42021256352), we searched PubMed, Web of Knowledge/Science, Ovid Medline, Embase and APA PsycINFO up to 16th November 2021, with no language/type of document restrictions. We included observational studies reporting at least one measure of vision in people of any age meeting DSM/ICD criteria for ADHD and in people without ADHD; or the prevalence of ADHD in people with and without vision disorders. Study quality was assessed with the Appraisal tool for Cross-Sectional Studies (AXIS). Random effects meta-analyses were used for data synthesis. Results We included 42 studies in the narrative synthesis and 35 studies in the meta-analyses (3,250,905 participants). We found meta-analytic evidence of increased risk of astigmatism (OR = 1.79 [CI: 1.50, 2.14]), hyperopia and hypermetropia (OR = 1.79 [CI: 1.66, 1.94]), strabismus (OR = 1.93 [CI: 1.75, 2.12]), unspecified vision problems (OR = 1.94 [CI: 1.38, 2.73]) and reduced near point of convergence (OR = 5.02 [CI: 1.78, 14.11]); increased lag (Hedge’s g = 0.63 [CI: 0.30, 0.96]) and variability (Hedge’s g = 0.40 [CI: 0.17, 0.64]) of the accommodative response; and increased self-reported vision problems (Hedge’s g = 0.63 [CI: 0.44, 0.82]) in people with ADHD compared to those without ADHD (with no significant heterogeneity). We also found meta-analytic evidence of no differences between people with and without ADHD on retinal nerve fiber layer thickness (Hedge’s g = −0.19 [CI: −0.41, 0.02]) and refractive error (Hedge’s g = 0.08 [CI: −0.26, 0.42]) (with no significant heterogeneity). Discussion ADHD is associated with some self-reported and objectively ascertained functional vision problems, but not with structural alterations of the eye. Further studies should clarify the causal relationship, if any, between ADHD and problems of vision. Trial registration PROSPERO registration: CRD42021256352.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association between ADHD and vision problems. A systematic review and meta-analysis

et al. 2022

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“…Hergüner and collaborators [ 36 ] also showed that ADHD children presented thinner nasal RNFL, being this positively correlated to the ADHD symptoms severity. The evaluation of RNFL and GCL thickness as possible biomarkers in children and adolescents diagnosed with ADHD has been described [ 37 , 38 ] once the RNFL contains RGCs with unmyelinated axons, which are considered to be an extension of the cerebral gray matter. The development of ADHD involves a delay in brain maturation, including a reduced volume of cerebral gray matter, which is linked to a disruption in the neurological pathways [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Attention-Deficit/Hyperactivity Disorder Animal Model Presents Retinal Alterations and Methylphenidate Has a Differential Effect in ADHD versus Control Conditions

et al. 2023

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Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent neurodevelopmental disorders. Interestingly, children with ADHD seem to experience more ophthalmologic abnormalities, and the impact of methylphenidate (MPH) use on retinal physiology remains unclear. Thus, we aimed to unravel the retina’s structural, functional, and cellular alterations and the impact of MPH in ADHD versus the control conditions. For that, spontaneously hypertensive rats (SHR) and Wistar Kyoto rats (WKY) were used as animal models of ADHD and the controls, respectively. Animals were divided into four experimental groups as follows: WKY vehicle (Veh; tap water), WKY MPH (1.5 mg/kg/day), SHR Veh, SHR MPH. Individual administration was performed by gavage between P28-P55. Retinal physiology and structure were evaluated at P56 followed by tissue collection and analysis. The ADHD animal model presents the retinal structural, functional, and neuronal deficits, as well as the microglial reactivity, astrogliosis, blood-retinal barrier (BRB) hyperpermeability and a pro-inflammatory status. In this model, MPH had a beneficial effect on reducing microgliosis, BRB dysfunction, and inflammatory response, but did not correct the neuronal and functional alterations in the retina. Curiously, in the control animals, MPH showed an opposite effect since it impaired the retinal function, neuronal cells, and BRB integrity, and also promoted both microglia reactivity and upregulation of pro-inflammatory mediators. This study unveils the retinal alterations in ADHD and the opposite effects induced by MPH in the retina of ADHD and the control animal models.

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“…Reviews suggested that the findings were inconsistent for the relation between early signs of deviating motor functioning or development and later ADHD [107,108] and on anxiety and social functioning in children and adolescents with ADHD [109]. ADHD in children was associated with a reduction in global retinal nerve fiber layer thickness (SMD = À0.23, 95% CI: À0.46 to À0.01) [110] and individuals with ADHD showed more oculomotor inhibition failure than control groups [111]. Similarly, altered electrophysiological performance monitoring (i.e., reduced error-related negativity and the error positivity amplitude) during cognitive tasks, indicative of difficulties in evaluating errors in performance, have been reported both in children and adults with ADHD [112].…”

Section: Other Associated Conditionsmentioning

confidence: 99%

A systematic meta-review of systematic reviews on attention deficit hyperactivity disorder

Chaulagain,

Lyhmann,

Halmøy

et al. 2023

Eur. Psychiatr.

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Background There are now hundreds of systematic reviews on attention deficit hyperactivity disorder (ADHD) of variable quality. To help navigate this literature, we have reviewed systematic reviews on any topic on ADHD. Methods We searched MEDLINE, PubMed, PsycINFO, Cochrane Library, and Web of Science and performed quality assessment according to the Joanna Briggs Institute Manual for Evidence Synthesis. A total of 231 systematic reviews and meta-analyses met the eligibility criteria. Results The prevalence of ADHD was 7.2% for children and adolescents and 2.5% for adults, though with major uncertainty due to methodological variation in the existing literature. There is evidence for both biological and social risk factors for ADHD, but this evidence is mostly correlational rather than causal due to confounding and reverse causality. There is strong evidence for the efficacy of pharmacological treatment on symptom reduction in the short-term, particularly for stimulants. However, there is limited evidence for the efficacy of pharmacotherapy in mitigating adverse life trajectories such as educational attainment, employment, substance abuse, injuries, suicides, crime, and comorbid mental and somatic conditions. Pharmacotherapy is linked with side effects like disturbed sleep, reduced appetite, and increased blood pressure, but less is known about potential adverse effects after long-term use. Evidence of the efficacy of nonpharmacological treatments is mixed. Conclusions Despite hundreds of systematic reviews on ADHD, key questions are still unanswered. Evidence gaps remain as to a more accurate prevalence of ADHD, whether documented risk factors are causal, the efficacy of nonpharmacological treatments on any outcomes, and pharmacotherapy in mitigating the adverse outcomes associated with ADHD.

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The association between attention-deficit/hyperactivity disorder and retinal nerve fiber/ganglion cell layer thickness measured by optical coherence tomography: a systematic review and meta-analysis

Cited by 12 publications

References 24 publications

Association between ADHD and vision problems. A systematic review and meta-analysis

Association between ADHD and vision problems. A systematic review and meta-analysis

Attention-Deficit/Hyperactivity Disorder Animal Model Presents Retinal Alterations and Methylphenidate Has a Differential Effect in ADHD versus Control Conditions

A systematic meta-review of systematic reviews on attention deficit hyperactivity disorder

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