Background <p>Attention Deficit Hyperactivity Disorder ADHD is a chronic neurodevelopmental disorder that affects both youngs and adults with an impact on the eyes and visual structure and functions.</p> Purpose <p>The aim of this study is to assess the Optical Coherence Tomography (OCT) Angiography findings in adult patients with ADHD.</p> Methods <p>This case-control study included 100 participants, grouped into two groups. The adult ADHD group (A) included 50 cases, and the control group (B) included 50 normal. Both groups were evaluated ophthalmologicaly and imaged by OCT angiography to assess the retinal thickness and vasculature.</p> Results <p>Both groups were matched regarding age, sex, BCVA, IOP, average K, axial L, and SER with no significant difference. The ADHD group showed decreased macular thickness, decreased peripapillary retinal nerve fiber layer thickness, and decreased vascularity in all quadrants compared to the control participants, <i>P</i> &lt; 0.05.</p> Conclusion <p>Patients with ADHD showed decreased macular thickness, peripapillary RNFL and retinal vasculature, which support the ocular affection in patients with ADHD.</p> Contribution <p>This study contributes to the understanding of retinal changes in patients with ADHD.</p> Clinical trial number <p>Not applicable.</p>