Association between ADHD and vision problems. A systematic review and meta-analysis,Molecular Psychiatry

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Association between ADHD and vision problems. A systematic review and meta-analysis
Molecular Psychiatry ( IF 11.0 ) Pub Date : 2022-08-05 , DOI: 10.1038/s41380-022-01699-0
Alessio Bellato _{1,

2} , John Perna _{3,

4} , Preethi S Ganapathy ₅ , Marco Solmi _{6,

7,

8,

9,

10,

11} , Andrea Zampieri ₁₂ , Samuele Cortese _{10,

13,

14,

15,

16} , Stephen V Faraone ₃

Affiliation

School of Psychology, University of Nottingham Malaysia, Semenyih, Malaysia.
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA.
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
Department of Ophthalmology & Visual Sciences, SUNY Upstate Medical University, Syracuse, NY, USA.
Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.
Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada.
Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program, University of Ottawa, Ottawa, ON, Canada.
School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.
Vittorio Emanuele III Hospital, Montecchio Maggiore, Vicenza, Italy.
Solent NHS Trust, Southampton, UK.
Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK.
Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA.
Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.

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.

中文翻译：

多动症与视力问题之间的关联。系统回顾和荟萃分析

目的

进行首次系统回顾和荟萃分析，评估注意力缺陷/多动障碍 (ADHD) 是否与眼部疾病和/或视觉功能改变相关。

方法

基于预注册协议（PROSPERO：CRD42021256352），我们检索了截至 2021 年 11 月 16 日的 PubMed、Web of Knowledge/Science、Ovid Medline、Embase 和 APA PsycINFO，没有语言/文档类型限制。我们纳入了观察性研究，报告了满足 DSM/ICD 多动症标准的任何年龄段的人和没有多动症的人的至少一项视力测量；或多动症在有和没有视力障碍的人中的患病率。使用横断面研究评估工具 (AXIS) 评估研究质量。随机效应荟萃分析用于数据合成。

结果

我们在叙述综合中纳入了 42 项研究，在荟萃分析中纳入了 35 项研究（3,250,905 名参与者）。我们发现散光 (OR = 1.79 [CI: 1.50, 2.14])、远视和远视 (OR = 1.79 [CI: 1.66, 1.94])、斜视 (OR = 1.93 [CI: 1.75, 2.12]), 未指定的视力问题 (OR = 1.94 [CI: 1.38, 2.73]) 和近会聚点减少 (OR = 5.02 [CI: 1.78, 14.11]); 宽松反应的滞后性增加（Hedge 的g = 0.63 [CI：0.30，0.96]）和可变性（Hedge 的g = 0.40 [CI：0.17，0.64]）；并增加了自我报告的视力问题（Hedge 的g = 0.63 [CI: 0.44, 0.82]) 患有 ADHD 的人与没有 ADHD 的人相比（没有显着的异质性）。我们还发现元分析证据表明，患有和未患有 ADHD 的人在视网膜神经纤维层厚度（Hedge's g = −0.19 [CI: -0.41, 0.02]）和屈光不正（Hedge's g = 0.08 [CI: -0.26] 方面没有差异, 0.42])（无显着异质性）。