Association between ADHD and vision problems. A systematic review and meta-analysis
Association between ADHD and vision problems. A systematic review and meta-analysis
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.
Attention Deficit Disorder with Hyperactivity/complications, Cross-Sectional Studies, Eye Diseases/complications, Humans, Prevalence
410-422
Bellato, Alessio
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Perna, John
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Ganapathy, Preethi S.
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Solmi, Marco
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Zampieri, Andrea
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Cortese, Samuele
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Faraone, Stephen V.
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January 2023
Bellato, Alessio
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Perna, John
65cef82a-eb2d-4e3e-ad76-5d9a9100770b
Ganapathy, Preethi S.
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Solmi, Marco
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Zampieri, Andrea
6555571b-66a1-493e-a84e-6c4a427ee4d7
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Faraone, Stephen V.
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Bellato, Alessio, Perna, John, Ganapathy, Preethi S., Solmi, Marco, Zampieri, Andrea, Cortese, Samuele and Faraone, Stephen V.
(2023)
Association between ADHD and vision problems. A systematic review and meta-analysis.
Molecular Psychiatry, 28 (1), .
(doi:10.1038/s41380-022-01699-0).
Abstract
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.
Text
s41380-022-01699-0
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More information
Accepted/In Press date: 1 July 2022
e-pub ahead of print date: 5 August 2022
Published date: January 2023
Additional Information:
Funding Information:
We thank McBride and colleagues for providing additional data when these were not present in the original papers. We also thank J.J. Sandra Kooij and Denise Bijlenga, Dawn K. DeCarlo, and Senerath J Perera, for providing additional details about their studies and helping us to determine the eligibility for the systematic review and meta-analyses.
Publisher Copyright:
© 2022, The Author(s).
Keywords:
Attention Deficit Disorder with Hyperactivity/complications, Cross-Sectional Studies, Eye Diseases/complications, Humans, Prevalence
Identifiers
Local EPrints ID: 476479
URI: http://eprints.soton.ac.uk/id/eprint/476479
ISSN: 1359-4184
PURE UUID: 1c2e293f-1095-4ee9-a7da-51d9865cea72
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Date deposited: 03 May 2023 17:19
Last modified: 17 Mar 2024 04:22
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Contributors
Author:
Alessio Bellato
Author:
John Perna
Author:
Preethi S. Ganapathy
Author:
Marco Solmi
Author:
Andrea Zampieri
Author:
Stephen V. Faraone
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