Abstract Details

Title The King-Devick (K-D) Test of Rapid Eye Movements: A Bedside Correlate of Disability and Quality of Life in Multiple Sclerosis

Topic Neuro-ophthalmology/Neuro-otology

Presentation(s) IN4 - (-)

Poster/Presentation
Number 004

Objective

Background Based on rapid number naming and requiring <1 minute, the K-D test captures impaired eye movements and saccades, findings that correlate with suboptimal brain function. K-D scores are significantly higher (worse) in athletes immediately following concussion, consistent with involvement of widely distributed visual pathways.

Design/Methods Patients with MS and controls completed the K-D test. Scores represent time to read single-digit numbers on 3 cards. Patients completed low-contrast acuity, high-contrast visual acuity (VA), spectral-domain OCT, NEI-VFQ-25, 10-Item Neuro-Ophthalmic Supplement, and MS Functional Composite.

Results In the MS cohort (n=81), K-D scores were higher (worse) than controls (54.7±15.7 vs. 41.2±7.2 seconds, p=0.003 least squares means, adjusting for age). Higher K-D scores in MS were associated with worse scores for vision-specific quality of life (p<0.001 for NEI-VFQ-25, 10-Item Supplement), binocular low-contrast acuity (2.5%, 1.25%, p<0.001), VA (p=0.003), timed 25-foot walk (p<0.001), 9-hole peg test (p=0.001), and PASAT3 (p=0.03, linear regression). Patients with ON history (p=0.003) or binocular low-contrast acuities below control group average (p=0.009, 2.5%, logistic regression) had worse K-D scores. Monocular vision (p=0.001-0.009) and RNFL thickness (p=0.001) were reduced in eyes of patients with worse K-D (adjusting for age and inter-eye correlations). Patients on disability did worse compared to those working full-time, accounting for age (p<0.001).

Conclusions The K-D test captures visual dysfunction, neurologic impairment, and quality of life in MS. K-D scores reflect work disability and structural changes by OCT. History of ON and abnormal binocular acuities were associated with worse K-D scores, suggesting that K-D captures afferent and efferent visual components. The K-D test should be considered as a rapid global visual performance measure.

Authors/Disclosures
Stephen Moster PRESENTER	No disclosure on file
Gary R. Cutter, PhD (University of Alabama At Birmingham)	Dr. Cutter has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biodelivery Sciences International, Biogen, Click Therapeutics, Genzyme, Genentech, GW Pharmaceuticals, Immunic, Klein-Buendel Incorporated, Medimmune/Viela Bio, Medday, Merck/Serono, Neurogenesis LTD, Novartis, Osmotica Pharmaceuticals, Perception Neurosciences, Recursion/Cerexis Pharmaceuticals, Regeneron, Reckover Pharmaceuticals, Roche, TG Therapeutics.. Dr. Cutter has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Applied Therapeutics, AI therapeutics, AMO Pharma, Astra-Zeneca, Avexis Pharmaceuticals, Biolinerx, Brainstorm Cell Therapeutics, Bristol Meyers Squibb/Celgene, CSL Behring, Galmed Pharmaceuticals, Green Valley Pharma, Horizon Pharmaceuticals, Immunic, Karuna Therapeutics, Mapi Pharmaceuticals LTD, Merck, Mitsubishi Tanabe Pharma Holdings, Opko Biologics,Prothena Biosciences, Novartis, Regeneron, Sanofi-Aventis, Reata Pharmaceuticals, NHLBI (Protocol Review Committee), University of Texas Southwestern, University of Pennsylvania, Visioneering Technologies, Inc.. Dr. Cutter has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JASN.
Steven Galetta, MD, FAAN (NYU Langone Medical Center)	Dr. Galetta has nothing to disclose.
Laura J. Balcer, MD, MSCE, FAAN (NYU Grossman School of Medicine)	Dr. Balcer has received personal compensation for serving as an employee of North American Neuro-Ophthalmology Society. An immediate family member of Dr. Balcer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Children's Hospital of Philadelphia.
	No disclosure on file

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