Retinal Nerve Fiber Layer Thickness in Children With ADHD

J Atten Disord. 2018 May;22(7):619-626. doi: 10.1177/1087054716664412. Epub 2016 Aug 16.


Objectives: The current study aims to compare retinal nerve fiber layer (RNFL) thickness, macular thickness, and macular volume between children with ADHD and a control group.

Method: The study group included children with ADHD and the control group consisted of age- and gender-matched participants without any psychiatric disorder. In all participants, RNFL thickness, macular thickness, and macular volume were measured by using spectral domain-optical coherence tomography (SD-OCT). ADHD symptom severity was evaluated by using parent-report measures, including Conners' Parent Rating Scale-Revised: Short Form (CPRS-R: S) and the Strengths and Difficulties Questionnaire: Parent Form (SDQ: P).

Results: We compared 90 eyes of 45 children with ADHD and 90 eyes of 45 controls. ADHD group had significantly lower RNFL thickness only in nasal quadrant than the controls. The remaining RNFL quadrants, macular thickness, and volume were not significantly different between groups. There was a reverse correlation between RNFL thickness and ADHD symptom severity.

Conclusion: This is the first study examining the RNFL thickness in ADHD. Our findings showed that nasal RNFL thickness was lower, indicating reduced unmyelinated axons in the retina of children with ADHD. The results of this study support the evidence that ADHD involves a lag in cortical maturation and this is measurable in the retina.

Keywords: ADHD; children; macular thickness; optical coherence tomography; retinal nerve fiber layer thickness.

Publication types

  • Comparative Study

MeSH terms

  • Attention Deficit Disorder with Hyperactivity / pathology*
  • Case-Control Studies
  • Child
  • Female
  • Humans
  • Male
  • Nerve Fibers, Unmyelinated / pathology*
  • Retinal Diseases / pathology*
  • Retinal Ganglion Cells / pathology*
  • Retinal Neurons / pathology
  • Tomography, Optical Coherence