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

Abstract

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.

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

“…Various case reports document potential ocular side effects of both stimulants and non-stimulants in patients with ADHD such as accommodation dysfunction, cataracts, mydriasis, cataracts and increased intraocular pressure [ 138 – 142 ]. Conversely, other authors [ 60 , 143 ] found no relationship between intraocular pressure and treatment with these medications. Stimulants and various non-stimulant medications used to treat ADHD are adrenergic agonizts, and therefore may affect autonomic regulation of various ocular structures [ 144 ].…”

“…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 ].…”

“… Grönlund et al [ 24 ] 42 ADHD; 50 no-ADHD Children and adolescents Axial length (of the eye); inner canthial distance; refractive error; anisometropia; astigmatism; heterophoria; visual acuity; hyperopia/hypermetropia; myopia; near point convergence; stereoacuity; vision problems; neuroretinal rim; optic cup and disc; index of tortuosity for veins of the optic fundus; Subtle morphological changes of the optic nerve and retinal vasculature were found in ADHD. Guvenmez et al [ 60 ] 40 ADHD; 36 no-ADHD Children and adolescents Intraocular pressure No statistically significant differences between ADHD and no-ADHD. Hergüner et al [ 62 ] 45 ADHD; 45 no-ADHD Children and adolescents Macular thickness and volume; retinal nerve fiber layer thickness Lower RNFL thickness in ADHD, in nasal quadrant.…”

Assessment of the lamina cribrosa in attention-deficit hyperactivity disorder

“…Previous reports have investigated the link between MPH and IOP, and no association was found. [ 25 26 27 ] Larrañaga-Fragoso et al . [ 25 ] examined the IOP in children with ADHD receiving MPH and found no IOP changes at 3 or 9 months.…”

“…Güvenmez et al . [ 26 ] also found no significant change in IOP before treatment and after 1- and 6-month treatment periods in children with ADHD. Duman et al .…”