Validation of dynamic random dot stereotests in pediatric vision screening

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Title: Validation of dynamic random dot stereotests in pediatric vision screening
Authors: Budai, Anna | Czigler, András | Mikó-Baráth, Eszter | Nemes, Vanda A. | Horváth, Gábor | Pusztai, Ágota | Piñero, David P. | Jandó, Gábor
Research Group/s: Grupo de Óptica y Percepción Visual (GOPV)
Center, Department or Service: Universidad de Alicante. Departamento de Óptica, Farmacología y Anatomía
Keywords: Amblyopia | Binocular vision | Vision screening | Dynamic random dot stereotest | Lang II
Knowledge Area: Óptica
Issue Date: Feb-2019
Publisher: Springer Berlin Heidelberg
Citation: Graefe's Archive for Clinical and Experimental Ophthalmology. 2019, 257(2): 413-423. doi:10.1007/s00417-018-4147-x
Abstract: Purpose: Stereo vision tests are widely used in the clinical practice for screening amblyopia and amblyogenic conditions. According to literature, none of these tests seems to be suitable to be used alone as a simple and reliable tool. There has been a growing interest in developing new types of stereo vision tests, with sufficient sensitivity to detect amblyopia. This new generation of assessment tools should be computer based, and their reliability must be statistically warranted. The present study reports the clinical evaluation of a screening system based on random dot stereograms using a tablet as display. Specifically, a dynamic random dot stereotest with binocularly detectable Snellen-E optotype (DRDSE) was used and compared with the Lang II stereotest. Methods: A total of 141 children (aged 4–14, mean age 8.9) were examined in a field study at the Department of Ophthalmology, Pécs, Hungary. Inclusion criteria consisted of diagnoses of amblyopia, anisometropia, convergent strabismus, and hyperopia. Children with no ophthalmic pathologies were also enrolled as controls. All subjects went through a regular pediatric ophthalmological examination before proceeding to the DRDSE and Lang II tests. Results: DRDSE and Lang II tests were compared in terms of sensitivity and specificity for different conditions. DRDSE had a 100% sensitivity both for amblyopia (n = 11) and convergent strabismus (n = 21), as well as a 75% sensitivity for hyperopia (n = 36). However, the performance of DRDSE was not statistically significant when screening for anisometropia. On the other hand, Lang II proved to have 81.8% sensitivity for amblyopia, 80.9% for strabismus, and only 52.8% for hyperopia. The specificity of DRDSE was 61.2% for amblyopia, 67.3% for strabismus, and 68.6% for hyperopia, respectively. Conversely, Lang II showed about 10% better specificity, 73.8% for amblyopia, 79.2% for strabismus, and 77.9% for hyperopia. Conclusions: The DRDSE test has a better sensitivity for the detection of conditions such as amblyopia or convergent strabismus compared with Lang II, although with slightly lower specificity. If the specificity could be further improved by optimization of the stimulus parameters, while keeping the sensitivity high, DRDSE would be a promising stereo vision test for screening of amblyopia.
Sponsor: This study was supported by the EFOP-3.6.1.-16-2016-00004: Comprehensive Development for Implementing Smart Specialization Strategies at the University of Pécs and by the European Union, co-financed by the European Social Fund KTIA_NAP_13-1-2013-0001: Brain Research Program; 2017-1.2.1.-NKP-2017-00002: Brain Research Program 2.0; OTKA K108747, PTE ÁOK-KA-2017-06, EFOP-3.6.3-VEKOP-16-2017-00009, 20765-3/2018/FEKUTSTRAT “Central mechanisms of stereopsis”, National Excellence Program TÁMOP-4.2.4.A/ 2-11/1-2012-0001.
ISSN: 0721-832X (Print) | 1435-702X (Online)
DOI: 10.1007/s00417-018-4147-x
Language: eng
Type: info:eu-repo/semantics/article
Rights: © Springer-Verlag GmbH Germany, part of Springer Nature 2018. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Peer Review: si
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