Grupo de Investigación Oftalmología Experimental, Departamento de Oftalmología, Optometría, Otorrinolaringología y Anatomía Patológica, Facultad de Medicina, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, España.
Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain.
Acta Ophthalmol. 2024 Aug;102(5):e842-e850. doi: 10.1111/aos.16657. Epub 2024 Feb 9.
The relationship between attention deficit hyperactivity disorder (ADHD) and visual impairment remains poorly understood, and the impact of visual impairment on the development of ADHD is uncertain. The aim of this study was to investigate the refractive profile and ocular biometric characteristics in patients diagnosed with ADHD and compare them with a control group. Additionally, we aimed to explore the potential influence of sex and medication intake.
A cohort of 100 participants, including 50 individuals with ADHD and 50 age- and sex-matched control subjects, was included in this study. Ocular biometric parameters were measured, and refractive error was assessed using cycloplegic and non-cycloplegic autorefraction. Subgroup analyses were performed within the ADHD group based on sex, medication intake and age to investigate potential associations with the ocular findings.
We observed no statistically significant differences in axial length, corneal topography parameters or anterior chamber characteristics between ADHD and control subjects. However, subgroup analysis within the ADHD group revealed that the prevalence of ametropia under cycloplegia was significantly higher in unmedicated (69.6%) compared to medicated (37.5%) (X(2) = 7.320, p = 0.026) participants. Pupil diameter was significantly larger in medicated (3.91 mm) compared to unmedicated (3.58 mm; p = 0.017) individuals. Males had flatter (p = 0.004) and thicker (p = 0.008) corneas than females. Older ADHD participants had higher refractive error (p = 0.008 for non-cycloplegic and p = 0.0.003 for cycloplegic), axial length (p = 0.002) and corneal astigmatism (p = 0.049).
Our study provides compelling evidence that individuals diagnosed with ADHD exhibit a similar incidence of refractive errors and ocular parameters compared to normal subjects. Nonetheless, the prevalence of refractive errors appears to be higher in unmedicated ADHD patients, suggesting the potential benefit of stimulant treatment. Additionally, stimulant use is associated with an increase in pupil diameter.
注意力缺陷多动障碍（ADHD）与视力损害之间的关系仍未得到充分理解，视力损害对 ADHD 发展的影响尚不确定。本研究旨在调查诊断为 ADHD 的患者的屈光状态和眼生物测量特征，并与对照组进行比较。此外，我们还旨在探讨性别和药物摄入的潜在影响。
本研究纳入了 100 名参与者，包括 50 名 ADHD 患者和 50 名年龄和性别匹配的对照组。测量眼生物测量参数，使用睫状肌麻痹和非睫状肌麻痹自动折射仪评估屈光不正。在 ADHD 组内根据性别、药物摄入和年龄进行亚组分析，以探讨与眼部发现的潜在关联。
我们未发现 ADHD 组和对照组之间眼轴长度、角膜地形图参数或前房特征存在统计学显著差异。然而，ADHD 组内的亚组分析显示，未用药组（69.6%）与用药组（37.5%）相比，在睫状肌麻痹下的屈光不正患病率明显更高（X²=7.320，p=0.026）。用药组（3.91mm）的瞳孔直径明显大于未用药组（3.58mm；p=0.017）。男性的角膜更平坦（p=0.004）和更厚（p=0.008）。年龄较大的 ADHD 患者的屈光不正（非睫状肌麻痹时为 p=0.008，睫状肌麻痹时为 p=0.003）、眼轴长度（p=0.002）和角膜散光（p=0.049）更高。
我们的研究提供了有力的证据，表明诊断为 ADHD 的个体与正常个体相比，表现出相似的屈光不正和眼部参数发生率。然而，未用药 ADHD 患者的屈光不正患病率似乎更高，提示兴奋剂治疗可能有益。此外，兴奋剂的使用与瞳孔直径的增加有关。
