Evaluation of ocular surface in children with attention deficit hyperactivity disorder with respect to
Emre Aydemir1, Gözde Aksoy Aydemir1, Merve Kalınlı2
1Ophthalmology Department, Adıyaman University Training and Research Hospital, Adıyaman, Turkey.
Insights
Methylphenidate treatment in children with attention deficit hyperactivity disorder (ADHD) was associated with dry eye disease indicators. Close ophthalmologic monitoring is recommended for these patients to prevent severe complications.
Area of Science:
- Ophthalmology
- Pediatrics
- Neuroscience
Background:
- Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children.
- Methylphenidate is a frequently prescribed stimulant medication for ADHD.
- The ocular surface effects of methylphenidate in pediatric ADHD patients are not fully understood.
Purpose of the Study:
- To screen the ocular surface of children with ADHD.
- To identify adverse effects of methylphenidate related to dry eye disease in this population.
Main Methods:
- A cross-sectional study involving children aged 5-18 years with ADHD (treated and untreated) and healthy controls.
- Evaluation of tear film break-up time, Ocular Surface Disease Index, tear meniscus height and area, and Schirmer test.
- Assessment of ADHD symptom severity using standardized rating scales.
Main Results:
- Children with ADHD on methylphenidate (Group B) showed significantly reduced tear film break-up time, tear meniscus height, tear meniscus area, and Schirmer test results compared to untreated ADHD children (Group A).
- No significant differences in ocular surface parameters were found between untreated ADHD children (Group A) and healthy children (Group C).
Conclusions:
- Children with ADHD on methylphenidate exhibit ocular surface changes indicative of dry eye disease.
- These findings highlight the need for regular ophthalmologic follow-up in pediatric ADHD patients using methylphenidate to mitigate potential sight-threatening complications.
Purpose:
This study aimed to screen the ocular surface of children with attention deficit hyperactivity disorder and identify the adverse effects of methylphenidate related to dry eye disease.
Methods:
This cross-sectional study included children with attention deficit hyperactivity disorder and healthy children (all aged 5-18 years). They were randomized into Group A (without methylphenidate treatment), Group B (with methylphenidate treatment), and Group C (healthy children). Tear film break-up time, Ocular Surface Disease Index questionnaire, tear meniscus height, tear meniscus area, and Schirmer test results were evaluated. Furthermore, symptom severity in attention deficit hyperactivity disorder was assessed by Turgay DSM-IV-based Child and Adolescent Behavioral Disorders Screening and Rating Scale and Conners Parent Rating Scale-48.
Results:
Groups A, B, and C consisted of 34, 40, and 60 individuals (n=34, 40, and 60 eyes; age=11.44 ± 2.79, 11.70 ± 2.83, and 11.96 ± 3.63 years, median age=12, 12, and 11.5 years), respectively. Tear film break-up time, Ocular Surface Disease Index, tear meniscus height, tear meniscus area, and Schirmer test results were not significantly different between Groups A and C (p=0.964, 0.336, 0.445, 0.439, and 0.759, respectively). However, Group B showed a significant decrease in tear film break-up time (10.50 ± 3.39 vs. 12.52 ± 2.46 s; p=0.005), tear meniscus height (307.40 ± 5.53 vs. 310.82 ± 7.30 µm; p=0.025), tear meniscus area (0.024 ± 0.0037 vs. 0.026 ± 0.0046 mm2; p=0.010) and Schirmer test (12.75 ± 3.96 vs. 15.41 ± 3.75 mm; p=0.004) results compared with Group A.
Conclusion:
Compared with healthy children, children with attention deficit hyperactivity disorder showed ocular surface parameters suggestive of dry eye disease despite taking methylphenidate. Thus, they require close ophthalmologic follow-up to prevent sight-threatening dry eye complications.
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