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Contrast Acuity and the King-Devick Test in Huntington's Disease
Ali G Hamedani1, Tanya Bardakjian1, Laura J Balcer2
1Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Neuro-Ophthalmology (Aeolus Press)
|October 5, 2020
Summary
Huntington's disease (HD) is linked to poorer low-contrast vision and slower number naming on the King-Devick test. These simple tests can objectively measure visual changes in HD patients.
Area of Science:
- Neuroscience
- Ophthalmology
- Genetics
Background:
- Saccadic eye movement abnormalities are early indicators of Huntington's disease (HD), but bedside quantification is challenging.
- Afferent visual pathway involvement in HD remains poorly understood.
Purpose of the Study:
- To evaluate afferent and efferent visual function in individuals with manifest Huntington's disease.
- To identify objective, quantifiable measures of visual impairment in HD.
Main Methods:
- Participants with manifest HD (n=19) and controls (n=20) underwent the King-Devick test for rapid number naming.
- Binocular high and low-contrast acuities were measured using Sloan letter charts.
- Pupillometry and validated questionnaires (NEI-VFQ-25) assessed visual function and quality of life.
Main Results:
- Patients with HD showed significantly slower King-Devick test times (102.9s vs 48.2s, p < .01).
- Low-contrast acuity was significantly reduced in HD patients, correlating with UHDRS motor scores (p < .05).
- No significant differences were observed in pupillary reactivity or self-reported vision-related quality of life.
Conclusions:
- Huntington's disease is associated with impaired low-contrast visual acuity and abnormal rapid number naming.
- The King-Devick test and low-contrast acuity measurement offer objective, quantifiable assessments of visual function in HD.
- These tests could be integrated into clinical rating scales for optimized HD monitoring.
