Dopaminergic medications as a preventive for myopia: insights derived from pediatric patients diagnosed with attention deficit hyperactivity disorder.

Background/objectives: This study investigated the impact of dopaminergic medications on myopia progression by comparing myopia susceptibility in ADHD patients treated with dopaminergic agents to those untreated. A non-ADHD cohort was also established to assess myopia risk compared to individuals with ADHD.

Subjects/methods: This population-based cohort study used Taiwan National Health Insurance data (2009-2020), stratifying participants by ADHD status. Myopia was identified using ICD-10 diagnostic codes, while ADHD-related drug usage (methylphenidate, atomoxetine, clonidine) was analyzed. Cox regression models compared hazard ratios (HRs) for myopia, with cumulative incidence curves generated via the Kaplan-Meier method.

Results: Adjusting for sex, age, comorbidities, and follow-up time, the untreated ADHD cohort had a 1.22-fold higher myopia risk (95% CI: 1.21-1.24) compared to the non-ADHD cohort. In contrast, ADHD patients receiving treatment showed a 39% reduced myopia risk (adjusted HR (aHR): 0.61; 95% CI: 0.59-0.62). An increased number of ADHD-related medications correlated with a notable myopia risk reduction: one drug (aHR: 0.50; 95% CI: 0.49-0.51) and two drugs (aHR: 0.28; 95% CI: 0.26-0.31).

Conclusions: Untreated ADHD in children is linked to a higher myopia risk than both non-ADHD individuals and treated ADHD patients. Dopaminergic treatments may provide a therapeutic avenue for mitigating myopia progression by enhancing dopamine signaling pathways. Key messages What is already known on this topic  Dopamine release in the retina inhibits myopia progression, and ADHD is linked to dopaminergic dysfunction. ADHD treatments like methylphenidate enhance dopamine signaling, but their effect on myopia risk has not been thoroughly studied. What this study adds  This study shows that untreated ADHD children have a higher risk of myopia, while dopaminergic treatments significantly reduce this risk. The use of multiple ADHD medications further strengthens the protective effect. How this study might affect research, practice or policy  These findings suggest that ADHD treatments may serve as a new approach for myopia prevention, encouraging cross-field research and consideration of systemic therapies for managing comorbid conditions.