Clavé Laura, Torrents Aurora
Grupo de Óptica Aplicada y Procesado de Imagen, Departamento de Óptica y Optometría, Universitat Politècnica de Catalunya-Barcelona Tech, Barcelona, Spain.
Hospital de Mataró, Servicio de Oftalmología, Consorci Sanitari del Maresme, Mataró, Spain.
Ophthalmic Physiol Opt. 2025 Jan;45(1):23-30. doi: 10.1111/opo.13411. Epub 2024 Oct 27.
Attention deficit and hyperactivity disorder (ADHD) is a neurodevelopmental condition commonly seen in children and adolescents, characterised by an increase in distractibility or inattention. Several studies have noted a higher rate of visual problems in this group, especially convergence insufficiency (CI), but when using different diagnostic criteria. The aim of this study was to evaluate visual function in ADHD children and non-ADHD controls to compare the different signs for diagnosis of CI.
In this prospective case-control study, a group of children aged 7-17 years, diagnosed with ADHD before the start of pharmacological treatment and matched for age and gender with non-ADHD controls were examined. Visual acuity (VA), objective and subjective refraction, accommodative amplitude and facility, heterophoria, positive and negative fusional vergences (PFV and NFV) and stereopsis were assessed.
Sixty participants (30 ADHD and 30 non-ADHD controls) were evaluated. There was no significant difference between the two groups for VA, refraction and accommodative abilities. There were significant differences in PFV and NFV: PFV break/recovery values for the ADHD and control groups were 18.9/16.2∆ and 26.9/22.1∆, respectively. Respective values for NFV were 15.7/13∆ and 19.3/15.9∆. Using the three signs of receded near point of convergence (NPC), decreased PFV and exophoria 4∆ greater at near than distance, the prevalence of CI was equivalent for the ADHD and controls (p = 0.34) If only two signs were considered for the CI diagnosis, (i.e., receded NPC and decreased PFV), then prevalence was significantly greater for the ADHD group (p < 0.01).
These results show a higher prevalence of binocular vision problems in the ADHD group. This suggests a relationship between vergence problems and ADHD, but the direction of this link remains unclear. Further studies with specific samples may be needed to understand fully the association between binocular vision disorders and ADHD.
注意缺陷多动障碍（ADHD）是儿童和青少年中常见的一种神经发育疾病，其特征为注意力分散或注意力不集中增加。多项研究指出，该群体中视力问题发生率较高，尤其是集合不足（CI），但研究采用了不同的诊断标准。本研究的目的是评估ADHD儿童和非ADHD对照儿童的视觉功能，以比较CI诊断的不同体征。
在这项前瞻性病例对照研究中，对一组年龄在7至17岁之间、在开始药物治疗前被诊断为ADHD且在年龄和性别上与非ADHD对照匹配的儿童进行了检查。评估了视力（VA）、客观和主观验光、调节幅度和调节灵活度、隐斜视、正和负融合性聚散（PFV和NFV）以及立体视。
对60名参与者（30名ADHD儿童和30名非ADHD对照）进行了评估。两组在VA、验光和调节能力方面无显著差异。PFV和NFV存在显著差异：ADHD组和对照组的PFV破裂/恢复值分别为18.9/16.2△和26.9/22.1△。NFV的相应值分别为15.7/13△和19.3/15.9△。使用集合近点后移（NPC）、PFV降低和近距外隐斜比远距大4△这三个体征，ADHD组和对照组的CI患病率相当（p = 0.34）。如果CI诊断仅考虑两个体征（即NPC后移和PFV降低），那么ADHD组的患病率显著更高（p < 0.01）。
这些结果表明ADHD组双眼视觉问题的患病率更高。这表明聚散问题与ADHD之间存在关联，但这种联系的方向仍不清楚。可能需要对特定样本进行进一步研究，以充分了解双眼视觉障碍与ADHD之间的关联。
