Ocular structural parameters in children with attention-deficit/hyperactivity disorder: a case-control study of drug-naïve and methylphenidate-treated patients

This study aimed to evaluate ocular structural parameters in children with attention-deficit/hyperactivity disorder (ADHD) and to investigate potential differences associated with Methylphenidate Hydrochloride (MPH) treatment. In this cross-sectional case-control study, 193 children were included and divided into three groups: Group 1 comprised 56 ADHD patients receiving MPH, Group 2 included 55 drug-naïve ADHD patients, and Group 3 consisted of 82 healthy controls. All participants underwent comprehensive ophthalmologic examinations, including cycloplegic refraction, intraocular pressure (IOP), corneal topography, specular microscopy, and spectral-domain optical coherence tomography (SD-OCT). Retinal nerve fiber layer (RNFL) thickness, macular ganglion cell complex (GCC), and retinal thickness in parafoveal and perifoveal regions were analyzed. No significant differences were observed in refraction, IOP, or corneal parameters among the three groups. OCT measurements showed that superior and inferior RNFL were significantly thinner in MPH-treated ADHD patients compared with controls (p = 0.010 and p 0.05). Anterior segment parameters were similar across groups, but retinal thickness differed between drug-naïve and MPH-treated ADHD patients, possibly related to disease characteristics or treatment effects, with no clear association with treatment duration. Prospective studies are needed to clarify these effects.