Incidence and risk of attention-deficit hyperactivity disorder in children with amblyopia: A nationwide cohort study.

Chien-Chia Su, Chia-Ying Tsai, Tzu-Hsun Tsai, I-Ju Tsai

Clinical & experimental ophthalmology 2019 Mar

filter terms:

The association between visual deficits and attention disorders has been reported but remains unproven. The objective of this study was to evaluate the risk of attention-deficit hyperactivity disorder (ADHD) in children with amblyopia. Population-based, cohort study. The dataset from the Taiwan National Health Insurance Research Database in 2000 to 2010. A 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. The primary outcome was the risk of ADHD. The secondary outcomes were age at ADHD onset and use of ADHD medication. During 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). The ADHD risk is higher in children with amblyopia. © 2019 The Authors. Clinical & Experimental Ophthalmology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Ophthalmologists.

Citation

Chien-Chia Su, Chia-Ying Tsai, Tzu-Hsun Tsai, I-Ju Tsai. Incidence and risk of attention-deficit hyperactivity disorder in children with amblyopia: A nationwide cohort study. Clinical & experimental ophthalmology. 2019 Mar;47(2):259-264