Abstract
Purpose :
Stereopsis is considered the highest level of binocularity, requiring good visual, oculomotor, and cortical function. Current stereoacuity tests can be limited by monocular cues, the need for polarized glasses, and limited ranges of non-linear scores. In this study, we assess the utility of the 3D, tablet-based, glasses-free Accurate STEReotest (ASTEROID) in comparison with the standard Titmus test in a pediatric population.
Methods :
Under a UCLA IRB protocol, children aged 5-13 years old in a pediatric ophthalmology practice were enrolled. Participants were organized by age (5-7 years vs 8-13 years) and visual acuity (VA, normal vs abnormal) with normal VA defined as 20/25 or better in both eyes. Each participant underwent both the ASTEROID (See 3D, Toronto, ON, Canada) and Titmus (Stereo Optical, Chicago, IL, USA) tests. Stereoacuity group was defined as fine (60 arc sec or better), moderate (61-200 arc sec), coarse (201-1199 arc sec) or very coarse or worse (1200 arc sec or worse). Agreement between tests was compared using a weighted Kappa (κ) statistic based on all 4 categories.
Results :
112 children were included in analysis: 28 aged 5-7 with normal VA, 30 aged 5-7 with abnormal VA, 34 aged 8-13 with normal VA, and 20 aged 8-13 with abnormal VA. Mean ASTEROID score was 688 ± 533 arc sec (range 13-1200). Of ASTEROID scores, 21 were fine, 21 were moderate, 16 were coarse, and 54 were very coarse or worse. Of Titmus scores, 45 were fine, 23 were moderate, 11 were coarse, and 33 were very coarse or worse. Comparing ASTEROID and Titmus test results overall, agreement was moderate (k = 0.53; 55% [62/112] overall agreement). Comparing test results by subgroup, agreement was fair for children 5-7 with abnormal VA (k = 0.31; 43% [13/30] overall agreement); moderate for children 5-7 with normal VA (k = 0.47; 54% [15/28] overall agreement) and children 8-13 with normal VA (k = 0.43; 50% [17/34] overall agreement); and substantial for children 8-13 with abnormal VA (k = 0.76; 85% [17/20] overall agreement).
Conclusions :
Current methods of testing stereoacuity have limitations. ASTEROID is a new digital tablet-based test that shows fair to substantial agreement with the Titmus test, especially for children over the age of 7. ASTEROID evaluates global stereopsis, does not require glasses, and provides a continuum of possible stereoacuity values, thus offering a promising modality in pediatric ophthalmology.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.