Abstract
Purpose :
Recent research has pointed to a possible connection between attention-deficit/hyperactivity disorder (ADHD) and keratoconus. This study seeks to examine the presence of this association within an international database.
Methods :
We performed a retrospective cohort study using the TriNetX database (Cambridge, MA, USA). Patients diagnosed with ADHD were selected using ICD-10 code F90. A control cohort was formed, comprising patients who had a general medical examination, as indicated by ICD-10 codes Z00.0-Z00.3. Individuals in the control cohort diagnosed with ADHD were excluded from the analysis. Patients eligible for inclusion were aged 18 years or younger and were seen between January 2018 and December 2021. Propensity score matching (PSM) with a 1:1 ratio was implemented, matching for demographics, ADHD treatments including stimulants and guanfacine, dry eye syndrome, vernal keratoconjunctivitis, and other important factors associated with keratoconus risk. Patients with a diagnosis of keratoconus preceding a diagnosis of ADHD were excluded from analysis. Demographic and other relevant data were analyzed, and relative risk ratios (RR) with 95% confidence intervals (CI) were calculated to evaluate the risk of developing keratoconus. Alpha level of 0.05 was used for significance.
Results :
Inclusion criteria were met by 364,154 patients with ADHD, and 2,233,828 patients in the control cohort. Post PSM, each cohort was comprised of 299,087 patients; the average age of patients was 9.1 years (SD: ± 3.1) (p = 0.0183). Post-PSM, no significant difference was found in matched variables (all p > 0.05). No significant difference in risk for keratoconus (RR: 0.878, 95% CI: 0.561-1.374) was found in the ADHD population compared to matched controls; 36 patients (0.012%) were diagnosed with keratoconus in the study group, compared to 41 patients (0.014%) in the control group.
Conclusions :
This retrospective study found no significant statistical correlation between ADHD and keratoconus, underlining the necessity for continued research to elucidate ocular health trends among those with ADHD.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.