| Title: |
Association of Attention-Deficit Hyperactivity Disorder With Myopia Among School Children |
| Authors: |
Chen, Xiu Nian; Zhang, Xiu Juan; Zhang, Yuzhou; Tang, Fangyao; Kam, Ka Wai; Ng, Mandy P.H.; Ip, Patrick; Wong, Ian C.K.; Zhang, Wei; Young, Alvin L.; Tham, Clement C.; Pang, Chi Pui; Chen, Li Jia; Yam, Jason C. |
| Publisher Information: |
C.V. Mosby Co. |
| Publication Year: |
2025 |
| Collection: |
University of Hong Kong: HKU Scholars Hub |
| Subject Terms: |
attention-deficit hyperactivity disorder; COVID-19 pandemic; myopia |
| Description: |
Purpose : To determine the relationship of attention-deficit hyperactivity disorder (ADHD) with myopia among school children. Methods : Children aged six to eight years in Hong Kong were recruited through a stratified, clustered randomized sampling frame and subsequently invited to undergo cycloplegic autorefraction and axial length measurements between 2016 and 2021. ADHD diagnoses were made by qualified physicians according to ICD-10 criteria. ADHD symptoms were assessed using the Strengths and Weaknesses of ADHD-symptoms and Normal-behaviors Questionnaire. Results : Totally 474 children with ADHD and 9950 control children were included. The age- and sex-adjusted myopia prevalence was lower in ADHD group (21%) versus controls (26%; P = 0.02). Multivariable regression analysis showed less myopia (odds ratio [OR] = 0.75; P = 0.03), higher spherical equivalent refraction (SER) ( β = 0.13; P = 0.04), and shorter axial length (AL) ( β = −0.07; P = 0.03) in children with ADHD. Specifically, ADHD with oral methylphenidate (MPH) treatment had less myopia (OR = 0.61, P = 0.04), higher SER ( β = 0.36; P < 0.001) and shorter AL ( β = −0.25; P < 0.001) compared to controls. Each additional month of MPH treatment was associated with a higher SER ( β = 0.02; P = 0.01) and shorter AL ( β = −0.01; P = 0.01). For each one-point increase in attention-deficit scores, children were found to be less myopic (OR = 0.88, P = 0.01), having higher SER ( β = 0.07; P = 0.003) and shorter AL ( β = −0.04; P = 0.001). The prevalence of myopia among ADHD increased to 32% during COVID-19 pandemic compared with 23% before COVID-19 pandemic ( P = 0.04). Conclusions : This cross-sectional study found that ADHD is associated with reduced myopia prevalence, more hyperopic SER, and shorter AL. Of note, the observed effect sizes of these associations were small; therefore the interpretation of the clinical meaning needs to be cautious. ; published_or_final_version |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
Investigative Ophthalmology & Visual Science; Investigative Ophthalmology & Visual Science, 2025, v. 66, n. 9; https://hub.hku.hk/handle/10722/358786; 66 |
| DOI: |
10.1167/iovs.66.9.36 |
| Availability: |
https://hub.hku.hk/handle/10722/358786; https://doi.org/10.1167/iovs.66.9.36 |
| Rights: |
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. |
| Accession Number: |
edsbas.21D721E2 |
| Database: |
BASE |