Stereoacuity and Related Factors: The Shandong Children Eye Study

PLoS One. 2016 Jul 8;11(7):e0157829. doi: 10.1371/journal.pone.0157829. eCollection 2016.

Abstract

Objective: To assess stereoacuity in a population-based sample of children and to examine ocular and systemic parameters related to stereoacuity.

Methods: Using a random cluster sampling method, four- to 18-year-old children from kindergartens, elementary schools, junior high schools and senior high schools from a rural area and an urban area in the East Chinese province of Shandong were included in the school-based cross-sectional study. All participants underwent a comprehensive eye examination including assessment of cycloplegic refraction and measurement of stereoacuity using the Titmus Stereo test.

Results: Out of 6364 eligible children, 5780 (90.8%) children with a mean age of 10.1 ± 3.2 years (range: 4 to 18 years) participated. Mean (± standard deviation) stereoacuity was 50.2 ± 50.6 arc seconds. Stereoacuity improved significantly (P<0.01) from the age group of 4 years to the age group of 6 to 7 years, then showed a plateau, deteriorated (P = 0.001) for both sexes from the age group of 9 years to the age group of 12 years (P<0.001), after which it improved (P = 0.001) again in the age group of 16 years or older to the pre-puberty values. In multivariate analysis, larger angle of binocular disparity (i.e., lower stereoacuity) was significantly associated with lower best corrected visual acuity (logMAR; P<0.001), higher intereye difference in refractive error (spherical equivalent) (P<0.001), higher cylindrical refractive error (P<0.001), higher refractive error (spherical value; P<0.001), higher intereye difference in best corrected visual acuity (logMAR) (P = 0.001), higher intereye difference in axial length (P = 0.001), and rural region of habitation (P = 0.006).

Conclusions: Stereoacuity as tested with the Titmus Stereo test improved significantly from an age of 4 years to an age of 6 and 7 years, then remained constant, temporarily deteriorated for both sexes in pre-puberty and puberty, after which it improved again to pre-puberty or better values at the age of 16 years or older. Lower stereoacuity was associated with lower best corrected visual acuity and higher intereye difference in best corrected visual acuity, higher cylindrical and spherical refractive errors, higher inter-eye difference in refractive error, higher intereye difference in axial length, and rural region of habitation.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • China
  • Cross-Sectional Studies
  • Eye*
  • Female
  • Humans
  • Male
  • Multivariate Analysis
  • Refraction, Ocular
  • Refractive Errors / diagnosis*
  • Reproducibility of Results
  • Rural Population
  • Schools
  • Surveys and Questionnaires
  • Urban Population
  • Visual Acuity*

Grants and funding

This work was funded by Jost P. Jonas, Consultant for Mundipharma Co. (Cambridge, UK), Alimera Co. (Alpharetta, GA, USA), Boehringer Ingelheim Co. (Ingelheim, Germany), Sanofi Co. (Paris, France), and Allergan Co. (Dublin, Ireland); Patent holder with Biocompatibles UK Ltd. (Franham, Surrey, UK) (Title: Treatment of eye diseases using encapsulated cells encoding and secreting neuroprotective factor and / or anti-angiogenic factor; Patent number: 20120263794), and patent application with University of Heidelberg (Heidelberg, Germany) (Title: Agents for use in the therapeutic or prophylactic treatment of myopia or hyperopia; Europäische Patentanmeldung 15 000 771.4). This study was also supported by National Health and Family Planning Commission of China (201302015), National Ministry of Science & Technology (2015BAI04B04), National Natural Science Foundation of China (81303081), Science and Technology Development Plan of Shandong Province (2014GGH219004) and Medicine and Health Development Plan of Shandong Province (2015WS0141).