Stereotest Comparison: Efficacy, Reliability, and Variability of a New Glasses-Free Stereotest

Purpose To test the validity of the ASTEROID stereotest as a clinical test of depth perception by comparing it to clinical and research standard tests. Methods Thirty-nine subjects completed four stereotests twice: the ASTEROID test on an autostereo 3D tablet, a research standard on a VPixx PROPixx 3D projector, Randot Circles, and Randot Preschool. Within 14 days, subjects completed each test for a third time. Results ASTEROID stereo thresholds correlated well with research standard thresholds (r = 0.87, P < 0.001), although ASTEROID underestimated standard threshold (mean difference = 11 arcsec). ASTEROID results correlated less strongly with Randot Circles (r = 0.54, P < 0.001) and Randot Preschool (r = 0.64, P < 0.001), due to the greater measurement range of ASTEROID (1-1000 arcsec) compared to Randot Circles or Randot Preschool. Stereo threshold variability was low for all three clinical stereotests (Bland-Altman 95% limits of agreement between test and retest: ASTEROID, ±0.37; Randot Circles, ±0.24; Randot Preschool, ±0.23). ASTEROID captured the largest range of stereo in a normal population with test-retest reliability comparable to research standards (immediate r = 0.86 for ASTEROID vs. 0.90 for PROPixx; follow-up r = 0.68 for ASTEROID vs. 0.88 for PROPixx). Conclusions Compared to clinical and research standards for assessing depth perception, ASTEROID is highly accurate, has good test-retest reliability, and measures a wider range of stereo threshold. Translational Relevance The ASTEROID stereotest is a better clinical tool for determining baseline stereopsis and tracking changes during treatment for amblyopia and strabismus compared to current clinical tests.