An Evaluation of the Agreement Between a Computerized Stereoscopic Game Test and the TNO Stereoacuity Test

Abstract

Purpose: Stereo-anomaly is commonly associated with amblyopia. An investigation was conducted to determine whether the measurements of stereoacuity obtained with the stereoacuity reference test (TNO Test) show an agreement with a computer stereoscope video game. Methods: Thirty-two subjects (mean age 9.37±2.00 years) with an amblyopia history were selected for a blind and randomized study of stereoacuity improvement through a new random dot game. A masked examiner measured the stereoacuity three times per subject using the TNO test (at the beginning, at the end and after 6 months of the treatment). A second masked examiner measured stereoacuity using the new computerized game after the TNO masked evaluation. Results: The Pearson’s correlation coefficient one test against the other was r2 = 0.767 and the Bland–Altman plot was r2= 0.069 (mean difference −0.03 log sec). Using three categories: poor (840–300 seconds of arc), coarse (480–210 seconds of arc) and moderate–fine stereoacuity (210–30 seconds of arc). Positive predictive values were 89.5% for moderate–fine; 72.7% for coarse; and 90.0% for poor stereoacuity. In addition, the agreement was evaluated using the Kappa coefficient (K= 0.743) with a 0.95 confidence interval and lower and upper Kappa limits were (0.628 and 0.858), respectively. Kappa coefficient and limits were still good when analyzing data before (K =0.663, 0.420 and 0.906) and after the treatment (K= 0.765, 0.632 and 0.899). Conclusion: The Computerized Stereoscopic Game test allows the measure of stereoacuity. It can be used for both the purpose of detecting stereo vision deficits or tracking stereo vision development.