Retinal Thinning in Attention Deficit Hyperactivity Disorder (ADHD): Structural Changes Detected by Spectral-Domain OCT

Abstract

Background/Objectives: Attention deficit hyperactivity disorder (ADHD) is a highly prevalent neurodevelopmental disorder. As the retina is an extension of the central nervous system, retinal imaging may provide insights into the ADHD pathophysiology. The objective of this work was to evaluate structural retinal alterations using optical coherence tomography (OCT) in ADHD patients compared to neurotypical controls. Methods: A case-control study involving 200 eyes (100 from 50 patients with ADHD and 100 from 50 controls) was conducted by comparing the thicknesses of the macular region (total retina, inner and outer retinal layers, ganglion cell layer plus inner plexiform layer [GCIPL], and macular retinal nerve fiber layer [mRNFL]), the peripapillary region (pRNFL), and the optic nerve head (ONH) parameters. Areas under the curve (AUCs) were calculated to evaluate diagnostic performance. Right and left eyes were analyzed separately. Results: Patients with ADHD showed a significant reduction in total and outer retinal thickness across several macular sectors in both eyes. No significant differences were observed in mRNFL, GCIPL, inner retina, pRNFL, or ONH parameters between groups. AUC values derived from ROC analysis indicate moderate diagnostic performance for total and outer retinal thickness in the macular region. Conclusions: ADHD is associated with retinal thinning in the macula (total and outer retinal thickness) in both eyes, suggesting the potential of OCT-based biomarkers for this condition.