Evaluation of retinal nerve fiber layer thickness, macular and optic nerve vascular structures using optical coherence tomography and optical coherence tomography angiography, and corneal analysis with pentacam topography in pediatric patients diagnosed with attention deficit hyperactivity disorder

Objective: To evaluate the retinal nerve fiber layer (RNFL), macular ganglion cell layer (GCL), choroidal thickness, vascular density, and corneal parameters in patients diagnosed with ADHD. Materials and Methods: A total of 64 patients diagnosed with ADHD and 58 healthy controls, who presented to the Child and Adolescent Psychiatry and Ophthalmology Clinics of Tokat Gaziosmanpaşa University Hospital, were included in the study. Following a comprehensive ophthalmological examination, measurements were obtained using optical coherence tomography (OCT), optical coherence tomography angiography (OCTA), and corneal tomography. The parameters were compared between the two groups. Results: There was no significant difference in macular ganglion cell layer thickness (GCLT) between the groups (p > 0.05). RNFL thickness was statistically significantly lower in the ADHD group (p < 0.05). Subfoveal choroidal thickness was also reduced in the ADHD group compared to controls (p < 0.05). Deep capillary plexus vascular density was significantly lower in patients with ADHD (p < 0.05). No significant differences were found between the groups in terms of corneal tomography parameters (p > 0.05). Conclusion: ADHD is a neurodevelopmental disorder characterized by a hypodopaminergic state. Dopamine is a key neuromodulator in vascular development. The dopamine deficiency in these patients may affect retinal and choroidal vascular development. Similar to delayed development in cerebral gray matter, RNFL development may also be delayed in this population. Keywords: Attention Deficit Hyperactivity Disorder, retinal nerve fiber layer, ganglion cell layer, choroid, optical coherence tomography, optical coherence tomography angiography, cornea.