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Diagnostic reliability and normative values of stereoacuity tests in preschool-aged children
Sonia Afsari1, Kathryn A Rose, Amy Shih-I Pai
1Department of Ophthalmology, Centre for Vision Research, Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia.
Insights
This study determined normal stereoacuity in preschool children and found the Randot Preschool Stereoacuity Test (RPST) most reliable for detecting vision problems. The findings establish normative data for key stereoacuity tests in young children.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Vision Science
Background:
- Stereoacuity is crucial for binocular vision and depth perception.
- Assessing stereoacuity in preschool children is challenging due to developmental factors.
- Reliable tests are needed to detect early-onset visual impairments.
Purpose of the Study:
- To establish normative stereoacuity thresholds in children aged 24-72 months.
- To evaluate the diagnostic reliability of three stereoacuity tests: Lang-Stereotest II (LangII), Stereo Smile Stereoacuity II Test (SSST), and Randot Preschool Stereoacuity Test (RPST).
- To compare the effectiveness of these tests in detecting amblyopia, strabismus, and anisometropia.
Main Methods:
- 1606 children aged 24-72 months underwent comprehensive eye examinations and stereoacuity testing.
- The LangII was attempted on all participants.
- The SSST and RPST were administered based on age and performance on other tests.
Main Results:
- Normative data (modes) for stereoacuity varied by test and age group, with RPST showing lower thresholds (better acuity) in older children (60 arcsec for 48-72 months).
- Age-adjusted areas under the curve (AUC) for detecting ocular conditions were highest for the RPST (0.92 for amblyopia, 0.82 for strabismus, 0.73 for anisometropia).
- The RPST demonstrated superior diagnostic reliability compared to the LangII and SSST.
Conclusions:
- Normative stereoacuity data were successfully established for the LangII, SSST, and RPST in preschool-aged children.
- The RPST exhibited the highest diagnostic accuracy for detecting amblyopia, strabismus, and anisometropia.
- The findings support the RPST as a reliable tool for vision screening in young children.
Aim:
To establish the range of normal stereoacuity thresholds and evaluate the diagnostic reliability of stereoacuity tests in preschool-aged children.
Methods:
1606 children, aged 24-72 months, had detailed eye examinations and stereoacuity testing. Lang-Stereotest II (LangII) was attempted on all children, Stereo Smile Stereoacuity II Test (SSST) was conducted on children aged < 30 months and on older children who could not complete the Randot Preschool Stereoacuity Test (RPST). The RPST was conducted on children aged ≥ 30 months and on some younger children who passed both the LangII and SSST.
Results:
Modes for the age groups 24-47 months and 48-72 months were: 200 arcsec for both age groups with the LangII test; 120 arcsec and 60 arcsec, respectively, with the SSST; 100 arcsec and 60 arcsec, respectively, with the RPST. Age-adjusted areas under the curve for detecting amblyopia, strabismus and anisometropia were: for the LangII test, 0.72, 0.68 and 0.60, respectively; for the SSST, 0.73, 0.80 and 0.57, respectively; for the RPST, 0.92, 0.82 and 0.73, respectively.
Conclusions:
Normative data for the LangII, RPST and SSST stereoacuity tests were determined for children aged 24-72 months. Sensitivity and specificity at individual disparity levels for detecting anisometropia, amblyopia and strabismus were also determined for RPST and SSST. Using area under age-adjusted receiver operating curves, the RPST was found to be the most reliable in detecting ocular conditions compared with the LangII and SSST tests.
