{
  "abstract": "Background: To investigate retinal nerve fibre layer (RNFL) and ganglion cell layer (GCL) thickness in different attention-deficit/hyperactivity disorder (ADHD) subtypes and their association with ADHD symptom severity.\n\nMethods: This is a cross-sectional study included children aged 6–8 years in Hong Kong. ADHD diagnoses were made by psychiatrists based on ICD-10 criteria.\n\nResults: Among 6431 children included in the study, 309 (4.80%) were diagnosed with ADHD and 6122 served as controls. Children with ADHD showed thinner p-RNFL, m-GCL, and p-GCL than controls (P = 0.002; P = 0.03; P = 0.003, respectively). Among the 309 ADHD, 149 were categorized as the combined (C) type, 74 as the Inattentive (IA) type, 39 as the hyperactive/impulsive (HI) type. The ADHD-C subtype exhibited thinner p-RNFL (mean difference [MD] = -2.47, P = 0.03), m-GCL (MD = -1.10, P = 0.03), and p-GCL (MD = -0.85, P = 0.007) than controls. The p-RNFL, m-GCL, and p-GCL thicknesses showed a decreasing trend across ADHD subtypes, being thickest in the ADHD-HI, followed by the IA, and then the C subtype (P = 0.04, P = 0.005, and P = 0.04, respectively). Higher SWAN-combined scores were associated with thinner p-RNFL, m-GCL, p-GCL, and m-RNFL (P = 0.04; P = 0.002; P = 0.005; P = 0.02, respectively).\n\nConclusion: RNFL and GCL thicknesses varied across ADHD subtypes. The combined subtypes exhibited thinner measurements than controls. An overall trend toward thinner RNFL and GCL thicknesses was observed across subtypes. RNFL and GCL thicknesses were negatively associated with severity of combined ADHD symptoms.\n\nClinical trial number: Not applicable.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12888-026-08422-1.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, 4/F Department of Ophthalmology and Visual Sciences, Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong SAR, China",
    "Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China",
    "Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China",
    "Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China",
    "Tianjin Eye Hospital, Tianjin, People’s Republic of China",
    "Hong Kong Eye Hospital, Hong Kong SAR, China",
    "Department of Ophthalmology, Hong Kong Children’s Hospital, Hong Kong SAR, China",
    "Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China",
    "Department of Paediatrics and Adolescent Medicine, Li Ka Shing, Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Xiu Juan Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiu Nian Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Yuzhou Zhang"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Ka Wai Kam"
    },
    {
      "affs": [
        3
      ],
      "name": "Ian C. K. Wong"
    },
    {
      "affs": [
        4
      ],
      "name": "Wei Zhang"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Alvin L. Young"
    },
    {
      "affs": [
        0,
        2,
        5,
        6,
        7
      ],
      "name": "Clement C. Tham"
    },
    {
      "affs": [
        0,
        7
      ],
      "name": "Chi Pui Pang"
    },
    {
      "affs": [
        0,
        2,
        7
      ],
      "name": "Li Jia Chen"
    },
    {
      "affs": [
        8
      ],
      "name": "Patrick Ip"
    },
    {
      "affs": [
        0,
        2,
        5,
        6,
        7
      ],
      "name": "Jason C. Yam"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/88z25sjhqyn79.bib",
  "cited_by": 0,
  "doi": "10.1186/s12888-026-08422-1",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13733042/",
  "id": "88z25sjhqyn79",
  "issns": [
    "1471-244X"
  ],
  "landing_url": "https://doi.org/10.1186/s12888-026-08422-1",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2738|Attention Deficit Hyperactivity Disorder"
    ]
  ],
  "openalex": "W7201851448",
  "pdf_url": null,
  "pmcid": "PMC13733042",
  "pmid": "42983672",
  "published": "2026-08-07",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/88z25sjhqyn79.ris",
  "sources": [
    {
      "first_seen": "2026-11-08T12:22:55Z",
      "native_id": "PMC13733042",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12888-026-08422-1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2738|Attention Deficit Hyperactivity Disorder",
      "subfield": "psychiatry"
    }
  ],
  "title": "Retinal nerve fibre layer, and ganglion cell layer thicknesses in children with ADHD: associations with subtypes and symptom severity",
  "title_text": "Retinal nerve fibre layer, and ganglion cell layer thicknesses in children with ADHD: associations with subtypes and symptom severity",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:22:55Z",
  "url": "https://research.draconitic.com/paper/88z25sjhqyn79",
  "venue": "BMC Psychiatry",
  "versions": []
}