Pupillometry measurement and its relationship to retinal structural changes in children with attention deficit hyperactivity disorder

Aslan, Mehmet; Uzun, Feyzahan; Fındık, Hüseyin; Kaçar, Murat; Okutucu, Murat; Hocaoğlu, Çiçek

doi:10.1007/s00417-020-04658-z

Cited by 6 publications

(6 citation statements)

References 44 publications

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“…Eleven studies analyzing anatomic ocular measures in people with and without ADHD were included in the meta-analyses. Two for axial length [ 24 , 54 ], four for ganglion cell layer thickness [ 55 – 58 ], three for intraocular pressure [ 56 , 59 , 60 ], eight for macular thickness [ 30 , 54 , 56 – 59 , 61 , 62 ], two for macular volume [ 61 , 62 ] and eight for RNFL thickness [ 30 , 54 – 58 , 61 , 62 ].…”

Section: Resultsmentioning

confidence: 99%

“… Akmatov et al [ 51 ] 258,662 ADHD; 2,327,958 no-ADHD Children and adolescents Unspecific eye problems Unspecific eye problems were found in 16% of patients with ADHD vs. 8.6% of those without. Aslan et al [ 61 ] 32 ADHD; 43 no-ADHD Children and adolescents Macular thickness and volume; retinal nerve fiber layer thickness No statistically significant differences between ADHD and no-ADHD. Ayyildiz and Ayyildiz [ 54 ] 30 ADHD; 30 no-ADHD Children and adolescents Axial length (of the eye); corneal curvature radius, diameter and thickness; macular thickness; retinal nerve fiber layer thickness Corneal thickness and axial length were significantly higher in ADHD, while corneal curvature radius was significantly lower.…”

Section: Methodsmentioning

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: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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

et al. 2022

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“…For example, children with ADHD have been shown to have higher pupillary velocity values in correlation with changes in thickness of the retinal nerve fiber layer and anxiety has been correlated with increased pupil sizes. 6,7 Specific disease processes affecting the retina, such as diabetic retinopathy, have expectedly shown progressive changes in pupillary dynamics with increasing disease severity. 8 Given the lack of a significant difference in our data when contrasted with Brown and colleagues' black participants, our study supports the use of previously established normative values when using pupillometry in the assessment of children with sickle cell disease, as it does not appear to influence pupil dynamics.…”

Section: Discussionmentioning

confidence: 99%

Pupil Size and Reactivity in Pediatric Patients With Sickle Cell Disease

Mack

Frankowski

Verkamp

et al. 2021

Journal of Pediatric Hematology/Oncology

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Pupil size and reactivity have been studied to objectively measure pain utilizing pupillometry measurements. Given the challenges associated with treating vaso-occlusive pain in pediatric patients with sickle cell disease, better assessment tools are needed. The objective of this study is to establish normative values for pupil size and reactivity in pediatric patients with sickle cell disease with the hope that pupillometry can be used as a tool to objectively measure pain and response to treatment with analgesic medications. Readings were performed using a NeurOptics PLR-2000 pupillometer. Forty-four males and 38 females, all black, were studied. Their median age was 11 years (range: 2 to 21). When comparing our participants with white participants in a previously published pediatric study, there was a significant difference in maximum constriction velocity (t = 3.45, P = 0.009), maximum pupil size (t = −5.57 mm, P < 0.0001), and minimum pupil size (t = −3.24, P = 0.002). There was no significant difference in pupil size and reactivity between patients with sickle cell disease and black patients without the disease when compared with the previously published study. Therefore, further investigation of pupillometry within the black population during vaso-occlusive crisis and in the "well state" is warranted in pediatric patients with sickle cell disease.

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“…For example, children with ADHD have been shown to have higher pupillary velocity values in correlation with changes in thickness of the retinal nerve fiber layer and anxiety has been correlated with increased pupil sizes. 6,7 Specific disease processes affecting the retina, such as diabetic retinopathy, have expectedly shown progressive changes in pupillary dynamics with increasing disease severity. 8 Given the lack of a significant difference in our data when contrasted with Brown et al's black participants, our study supports the use of previously established normative values when using pupillometry in the assessment of children with sickle cell disease, as it does not appear to influence pupil dynamics.…”

Section: Discussionmentioning

confidence: 99%

Pupil Size and Reactivity in Pediatric Patients with Sickle Cell Disease

Mack

Frankowski

Verkamp

et al. 2020

Preprint

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Background/Objectives: Pupil size and reactivity have been studied in adult and pediatric populations to objectively measure pain which showed that pupillometry is a promising biomarker for pain measurement. Vaso-occlusive crisis, is a common complication of sickle cell disease (SCD) and better assessment tools are needed. The objective of this study is to establish normative values for pupil size and reactivity in pediatric patients with SCD with the hope that pupillometry can be used as a tool to objectively measure pain and response to treatment. Design/Methods: Institutional review board (IRB) approved prospective study enrolled 82 patients with SCD. Readings were performed using a NeurOptics PLR-2000 pupillometer. The following measures were collected: resting pupil size, % change in pupil size, pupil constriction velocity, and pupil dilation velocity. Results: Forty-four males and 38 females, all black, were studied. Median age was 11 years (range:2-21). The mean minimum and maximum pupil sizes were 3.52mm and 5.08mm, respectively. The mean dilation velocity and maximum constriction velocity were 1.03mm/s and -4.48mm/s, respectively. When comparing our participants with white participants in a previously published pediatric study, there was a significant difference in maximum constriction velocity, maximum pupil size, and minimum pupil size.1 There was no significant difference when comparing means for these parameters. Conclusion: There was no significant difference in pupil size and reactivity between patients with SCD and black patients without the disease. Further investigation of pupillometry within the black population during vaso-occlusive crisis and in the "well state" is warranted in pediatric patients with SCD.

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Pupillometry measurement and its relationship to retinal structural changes in children with attention deficit hyperactivity disorder

Cited by 6 publications

References 44 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

Pupil Size and Reactivity in Pediatric Patients With Sickle Cell Disease

Pupil Size and Reactivity in Pediatric Patients with Sickle Cell Disease

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