Guanfacine for ADHD Increases Corneal Aberrations in Youth

TOPLINE:

Oral use of guanfacine by children and adolescents newly diagnosed with attention-deficit/hyperactivity disorder (ADHD) increases corneal aberrations but does not affect other ocular parameters.

METHODOLOGY:

• Researchers conducted a prospective study to assess the effects of guanfacine treatment on the anterior and posterior eye segments over a 6-month period in 32 children and adolescents (mean age, 9 years; 944% boys) with ADHD who were admitted to a child psychiatry department at a hospital in Istanbul.
• The participants had been receiving methylphenidate for at least 1 year before guanfacine was added to the treatment regimen.
• They underwent detailed ophthalmologic evaluations twice: Before and 6 months after starting to receive guanfacine.
• Ocular parameters such as refractive error, intraocular pressure, corneal aberrations, central macular thickness, retinal nerve fiber layer, and choroidal thickness were assessed.

TAKEAWAY:

• From baseline to 6 months, guanfacine treatment led to a significant increase in corneal aberrations, including total root mean square (RMS; P = .029), RMS low-order aberration (P = .014), and coma aberrations (P less than .05).
• No significant changes were observed in other ocular parameters such as choroidal thickness, refractive error, intraocular pressure, retinal nerve fiber layer, or central corneal or macular thickness.

IN PRACTICE:

“Ocular adverse effects should be considered when prescribing guanfacine treatment, and regular ophthalmic examinations should be recommended during guanfacine treatment,” the authors of the study wrote.

SOURCE:

This study was led by Işıl Merve Torun, of the Department of Ophthalmology at the Medical Health Sciences University, Sultan Abdulhamid Han Training and Research Hospital, in Istanbul, Turkey. It was published online on January 31, 2025, in BMC Ophthalmology.

LIMITATIONS:

Children treated only with guanfacine could not be analyzed as guanfacine is not a first-line therapy for ADHD. The sample size was small with only 6 months of follow-up. Some participants withdrew from the treatment due to adverse effects, affecting this study’s continuity.

DISCLOSURES:

This study did not receive any specific funding support. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.