Abstract
ImportanceThe association between visual deficits and attention disorders has been reported but remains unproven.BackgroundThe objective of this study was to evaluate the risk of attention‐deficit hyperactivity disorder (ADHD) in children with amblyopia.DesignPopulation‐based, cohort study.ParticipantsThe dataset from the Taiwan National Health Insurance Research Database in 2000 to 2010.MethodsA total of 6817 patients aged <18 years with newly diagnosed amblyopia were identified. Four age‐ and sex‐matched controls without amblyopia were included for each patient, that is, 27268 controls.Main Outcome MeasuresThe primary outcome was the risk of ADHD. The secondary outcomes were age at ADHD onset and use of ADHD medication.ResultsDuring a mean observation period of 7.18 years, the incidence of ADHD per 1000 person‐years was 7.02 in the amblyopia group and 4.61 in the control group (P < 0.0001). The ADHD risk in the amblyopia group was 1.81 times that in the control group (hazard ratio 1.81; 95% confidence interval 1.59‐2.06). After stratification by amblyopia subtype, the greatest risk was in the deprivation type (hazard ratio 2.14; 95% confidence interval 1.56‐2.92) followed by the strabismic (hazard ratio 2.09; 95% confidence interval 1.15‐3.79) and refractive (hazard ratio 1.76; 95% confidence interval 1.54‐2.02) types. Age at ADHD onset was younger in the amblyopia group (median 8.14 vs 8.45 years; P = 0.0096). The average duration of neuropsychiatric medication use was comparable between groups (P = 0.98).Conclusions and RelevanceThe ADHD risk is higher in children with amblyopia.
Highlights
Amblyopia is a common cause of vision impairment and has prevalence rates of approximately 2% in preschool children and 3% in adult population.[1,2] It is characterized by impaired vision in one or both eyes because of disruption of normal visual stimuli and underdevelopment of the visual cortex because of strabismus, pattern deprivation or inadequate refractive error correction during the critical period.[3]
6817 children diagnosed with amblyopia and 27268 controls matched for age and sex were recruited for this study
Multivariate Cox regression analysis showed that the risk of Attention-deficit hyperactivity disorder (ADHD) in the amblyopia group was 1.8 times that in the control group after adjustment for age, sex and medical comorbidities
Summary
Amblyopia is a common cause of vision impairment and has prevalence rates of approximately 2% in preschool children and 3% in adult population.[1,2] It is characterized by impaired vision in one or both eyes because of disruption of normal visual stimuli and underdevelopment of the visual cortex because of strabismus, pattern deprivation or inadequate refractive error correction during the critical period.[3]. Amblyopia is a common cause of vision impairment and has prevalence rates of approximately 2% in preschool children and 3% in adult population.[1,2]. It is characterized by impaired vision in one or both eyes because of disruption of normal visual stimuli and underdevelopment of the visual cortex because of strabismus, pattern deprivation or inadequate refractive error correction during the critical period.[3]. Recent studies have demonstrated that abnormal visual experience may influence the microstructural integrity of the white matter and cortical changes.[4,5]. Attention-deficit hyperactivity disorder (ADHD) is one of the most prevalent neurodevelopmental disorders in
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