Choroidal Vascular Index in Patients With Attention-Deficit/Hyperactivity Disorder and Methylphenidate.

Purpose: To investigate choroidal vascularity in children with attention-deficit/hyperactivity disorder (ADHD) who were not receiving therapy, children with ADHD who were regularly taking methylphenidate (MPH), and healthy controls.

Methods: The study included three groups: patients with newly diagnosed ADHD without treatment, patients diagnosed as having ADHD who were already being treated with oral MPH, and controls. Both choroidal vascularity index (CVI) and choroidal thickness were measured using an enhanced-depth imaging mode of spectral-domain optical coherence tomography (EDIOCT) (Spectralis; Heidelberg Engineering GmbH).

Results: There was a significant difference in CVI and stromal area between groups. Post-hoc univariate analysis showed that CVI was significantly lower in patients with ADHD treated with MPH compared with the other groups (P < .001, for each); however, there was no difference between the treatment-free ADHD group and controls (P = .305). In contrast, stromal area was significantly higher in patients with ADHD treated with MPH than the other groups (P < .001, for each group). The correlation of CVI with MPH treatment duration in patients with ADHD treated with MPH showed a significant, moderate negative correlation (P = .01, r = - 0.66).

Conclusions: CVI is reduced in patients with ADHD treated with MPH, and the decrease in CVI becomes significant with increasing duration of MPH treatment. This result reflects an indirect effect of MPH treatment on choroidal vascular structures. [J Pediatr Ophthalmol Strabismus. 2023;60(6):411-416.].