{"id":213806,"date":"2025-05-12T06:04:13","date_gmt":"2025-05-12T11:04:13","guid":{"rendered":"https:\/\/lifeboat.com\/blog\/2025\/05\/retinal-fundus-imaging-as-biomarker-for-adhd-using-machine-learning-for-screening-and-visual-attention-stratification"},"modified":"2025-05-12T06:04:13","modified_gmt":"2025-05-12T11:04:13","slug":"retinal-fundus-imaging-as-biomarker-for-adhd-using-machine-learning-for-screening-and-visual-attention-stratification","status":"publish","type":"post","link":"https:\/\/lifeboat.com\/blog\/2025\/05\/retinal-fundus-imaging-as-biomarker-for-adhd-using-machine-learning-for-screening-and-visual-attention-stratification","title":{"rendered":"Retinal fundus imaging as biomarker for ADHD using machine learning for screening and visual attention stratification"},"content":{"rendered":"<p><a class=\"aligncenter blog-photo\" href=\"https:\/\/lifeboat.com\/blog.images\/retinal-fundus-imaging-as-biomarker-for-adhd-using-machine-learning-for-screening-and-visual-attention-stratification.jpg\"><\/a><\/p>\n<p>Few studies have directly examined the relationship between retinal structure and cognitive function in children. Provost <i>et al.<\/i> reported an inverse correlation of the dense retinal microvascular network with behavioral outcomes and sustained attention ability, which is consistent with our results<sup><a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 66\" title=\"Provost, E. B. et al. Denser Retinal Microvascular Network Is Inversely Associated With Behavioral Outcomes and Sustained Attention in Children. Front. Neurol. 12, 547033 (2021).\" href=\"https:\/\/www.nature.com\/articles\/s41746-025-01547-9#ref-CR66\" id=\"ref-link-section-d271162e1493\">66<\/a><\/sup>. However, no significant correlation between RNFL thickness and symptom severity of ADHD or EF performance has been reported. This indicates that although RNFL measurements may reflect certain neural characteristics of ADHD, they do not directly correlate with functional impairments<sup><a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 67\" title=\"Kaymak, D., G\u00fcndo\u011fmu\u015f, \u0130., Dalk\u0131ran, M., K\u00fc\u00e7\u00fckevcilio\u011flu, M. & Uzun, \u00d6. Retinal Nerve Fiber Layer Thickness and Its Relationship With Executive Functions in Adult Attention Deficit Hyperactivity Disorder Patients. Psychiatry Investig. 18, 1171&ndash;1179 (2021).\" href=\"https:\/\/www.nature.com\/articles\/s41746-025-01547-9#ref-CR67\" id=\"ref-link-section-d271162e1497\">67<\/a><\/sup>. Our ML model successfully stratified EF severity using retinal photograph analysis but did not achieve stratification of symptom severity as measured using the K-ARS. This corroborates the complexity of ADHD diagnosis and suggests that retinal biomarkers, although potentially valuable, should be considered complementary to conventional diagnostic tools, such as the DSM-5.<\/p>\n<p>Nevertheless, the correlation between the retinal structure and EF deficits in ADHD supports its potential as a therapeutic biomarker. Notably, methylphenidate (MPH), a dopamine reuptake inhibitor, enhances various aspects related to attention in individuals with ADHD<sup><a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 68\" title=\"Schrantee, A. et al. Age-Dependent Effects of Methylphenidate on the Human Dopaminergic System in Young vs Adult Patients With Attention-Deficit\/Hyperactivity Disorder: A Randomized Clinical Trial. JAMA Psychiatry 73,955 (2016).\" href=\"https:\/\/www.nature.com\/articles\/s41746-025-01547-9#ref-CR68\" id=\"ref-link-section-d271162e1505\">68<\/a><\/sup>, and significant differences in terms of parafoveal thickness were observed between the ADHD and TD groups, indicating a possible influence of MPH on retinal circulation<sup><a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 69\" title=\"Lee, J. S. et al. Regional cerebral blood flow in children with attention deficit hyperactivity disorder: Comparison before and after methylphenidate treatment. Hum. Brain Mapp. 24157&ndash;164 (2005).\" href=\"https:\/\/www.nature.com\/articles\/s41746-025-01547-9#ref-CR69\" id=\"ref-link-section-d271162e1509\">69<\/a><\/sup>. Additionally, retinal thickness was positively correlated with the duration of MPH use, with greater retinal thickness in children undergoing treatment with MPH for 24 months<sup><a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 70\" title=\"Tarakcioglu, H. N. et al. Foveal avascular zone and vessel density in children with attention deficit hyperactivity disorder. Int. Ophthalmol. 40, 1155&ndash;1162 (2020).\" href=\"https:\/\/www.nature.com\/articles\/s41746-025-01547-9#ref-CR70\" id=\"ref-link-section-d271162e1513\">70<\/a><\/sup>. Complementing these clinical findings, the animal study has shown that MPH exerts beneficial effects on the retina by reducing microgliosis, mitigating blood-retinal barrier dysfunction, and attenuating inflammatory responses<sup><a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 71\" title=\"Sanches, E. S. et al. Attention-Deficit\/Hyperactivity Disorder Animal Model Presents Retinal Alterations and Methylphenidate Has a Differential Effect in ADHD versus Control Conditions. Antioxidants 12,937 (2023).\" href=\"https:\/\/www.nature.com\/articles\/s41746-025-01547-9#ref-CR71\" id=\"ref-link-section-d271162e1517\">71<\/a><\/sup>.<\/p>\n<p>This study has some limitations. First, the dataset was derived from two hospitals in South Korea, potentially limiting the generalizability of our findings to broader populations. Future validation with external datasets encompassing diverse geographical and demographic settings is essential to confirm the global applicability of retinal biomarkers in ADHD screening and visual attention stratification. Nevertheless, our study provides robust preliminary evidence for the potential utility of retinal photographs in this context. Second, while retinal photographs were effective in identifying structural differences associated with ADHD, the two-dimensional nature of these images provides limited information. Although optical coherence tomography (OCT), incorporating three-dimensional imaging techniques, has been explored in ADHD and ASD populations, its results have been inconsistent<sup><a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 25\" title=\"Li, S. L. et al. The association between attention-deficit\/hyperactivity disorder and retinal nerve fiber\/ganglion cell layer thickness measured by optical coherence tomography: a systematic review and meta-analysis. Int. Ophthalmol. 41, 3211&ndash;3221 (2021).\" href=\"https:\/\/www.nature.com\/articles\/s41746-025-01547-9#ref-CR25\" id=\"ref-link-section-d271162e1524\">25<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 72\" title=\"Dastamooz, S. et al. A systematic review and meta-analysis on the ocular characteristics in children and adolescents with neurodevelopmental disorders. Sci. Rep. 13, 19397 (2023).\" href=\"https:\/\/www.nature.com\/articles\/s41746-025-01547-9#ref-CR72\" id=\"ref-link-section-d271162e1527\">72<\/a><\/sup>. Retinal photography, due to its rapidity and accessibility, may serve as a practical screening tool. On the one hand, advanced imaging modalities such as optical coherence tomography angiography (OCT-A) could complement retinal photography by capturing microvascular changes, presenting an alternative for further biomarker investigation. Third, our study focused on participants within a narrow age range (mean: approximately 9 years), which limits the generalizability of the findings to other developmental stages. Future research should investigate whether retinal biomarkers vary across age groups, considering the developmental trajectories of ADHD.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Few studies have directly examined the relationship between retinal structure and cognitive function in children. Provost et al. reported an inverse correlation of the dense retinal microvascular network with behavioral outcomes and sustained attention ability, which is consistent with our results66. However, no significant correlation between RNFL thickness and symptom severity of ADHD or EF [\u2026]<\/p>\n","protected":false},"author":427,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11,6],"tags":[],"class_list":["post-213806","post","type-post","status-publish","format-standard","hentry","category-biotech-medical","category-robotics-ai"],"_links":{"self":[{"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/posts\/213806","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/users\/427"}],"replies":[{"embeddable":true,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/comments?post=213806"}],"version-history":[{"count":0,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/posts\/213806\/revisions"}],"wp:attachment":[{"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/media?parent=213806"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/categories?post=213806"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/tags?post=213806"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}