A child developed solar maculopathy while being treated with methylphenidate (Ritalin) for attention deficit hyperactivity disorder (ADHD). The patient was evaluated by color fundus photography, fluorescein angiography and optical coherence tomography (OCT). OCT images demonstrate localized loss of the hyper-reflective layer normally attributed to the photoreceptors’ outer segments and partial loss of the retinal pigment epithelial hyper-reflective layer. Central nervous system stimulants including methylphenidate can cause mydriasis, increasing the risk of macular damage during sungazing. Methylphenidate is widely used for ADHD. The present case highlights long term retinal findings in solar retinopathy, their differential diagnosis and the potential hazardousness of sungazing during methylphenidate therapy.
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