A Single Low-Dose of Methylphenidate Improves Abnormal Visual Field Testing

ABSTRACT

Purpose

To evaluate the effect of methylphenidate on visual field testing in healthy adults with abnormal visual field results.

Methods

This prospective, randomized, controlled interventional clinical trial comprised all patients who had abnormal visual field test results and normal eye examination and ophthalmic history. Eligible patients were randomly assigned to either the study group or the control group. All patients repeated their visual field testing. Study group patients received a single dose of 10 mg methylphenidate prior to that. The main outcome measures were the percent difference in mean deviation and pattern standard deviation between the second and first visual fields.

Results

The methylphenidate group had greater improvement in all parameters. Mean deviation improved by median 68% (IQR 19%–78%) in the methylphenidate group vs. 27% [−5% to 55%] in the controls. However, this was not statistically significant (p = .83). Pattern standard deviation improved by median 49% (22%–59%) vs. 7% [−9% to 45%], respectively (p = .012). The visual fields were also reviewed by 3 masked experienced ophthalmologists. They indicated that the second visual field improved in 76.2% of the methylphenidate group vs. 48.5% of the controls (p = .04). A normal repeat visual field occurred in 57.7% vs. 21.2%, respectively. A subgroup analysis of patients with prior experience in visual field testing yielded an even more striking improvement in the methylphenidate group vs. controls.

Conclusions

A single low dose of methylphenidate can improve visual field testing in subjects without ocular pathology, and even more in those with prior experience in perimetry.

KEYWORDS:

• Methylphenidate
• visual field tests
• perimetry
• visual fields
• visual field exam

Acknowledgments

We thank Professor Dov Weinberger and Dr. Moshe Lusky for their assistance and participation in the conduction of this study.

Ethics approval

The study protocol was approved by the institutional review board and adhered to the tenets of the declaration of Helsinki. The study is registered with the Clinical Trials Registry (NCT02162381).

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.