Macular pigment changes after cataract surgery with yellow-tinted intraocular lens implantation

Akira Obana; Yuko Gohto; Ryo Asaoka

doi:10.1371/journal.pone.0248506

Peer Review History

Original SubmissionDecember 17, 2020
11 Feb 2021 Decision Letter - Alfred S Lewin, Editor PONE-D-20-39598 Macular pigment changes after cataract surgery with yellow-tinted intraocular lens implantation PLOS ONE Dear Dr. Obana, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please add a schematic of the absorbance spectra the ocular media (cornea, lens, retina [e.g. MP and other chromophores]) to help readers understand the region of high-energy, short-wavelength light. Please provide spectral transmission of the SN60 WF, XY1, YP2.2 and PCB00V IOLs. Please ensure that your decision is justified on PLOS ONE’s publication criteria and not, for example, on novelty or perceived impact. 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We will update your Data Availability statement on your behalf to reflect the information you provide. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? 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Reviewer #1: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: 1) Adding a schematic of the absorbance spectra the ocular media would be beneficial (cornea, lens, retina [e.g. MP and other chromophores]) to help readers understand the region of high-energy, short-wavelength light 2)The authors have correctly pointed it out but direct comparisons of RRS and 2-wavelength AF and HFP are inappropriate. Differences in measured MPOD among the 3 are difficult to assign meaning to. 3) Please provide spectral transmission of the SN60 WF, XY1, YP2.2 and PCB00V IOLs. This might help the reader understand the absorption contribution relative to the other ocular components 4) Although the author states that "No L/Z supplementation was utilized, a dietary questionnaire control might be useful 5) Tbl 2 and 3 show that virtually all of the MPOD and MPOV values increased at every position. As MP cannot be synthesized de novo and must be obtained through diet, I'm interested to learn more about the etiology. I ask out of clinical interest because the theory posited in Lines 74-79 states that increased transmission of SW light leads to decreased MP but the theory described in Lines 233-239 state that increased retinal irradiation following cataract surgery leads to enhanced retinal capture of circulating L/Z due to increased isomerization. Should all ECCE patients be using L/Z supplementation? 6) Lines 127-129 discussed analysis of RRS and MPOV @ 1.5 degrees measured through FAF. Comparison of these values may be inappropriate due to technique differences. 7) A table displaying change rate for time pints and eccentricities would be valuable ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0248506.r001
Revision 1
25 Feb 2021 Author Response Thank you for organizing a quick review. We appreciate the reviewers’ comments and have revised our manuscript accordingly. The following details are our point-by-point responses (black font) to the reviewers’ comments (blue font, Italic). The main revised parts are indicated in the proofreading file in red. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. We checked our manuscript according to PLOS ONE’s style and we believe this manuscript fits it. If not, please let us know. We will revise it quickly. 2. Please provide a table of patient demographics. Thank you for your suggestion. We added patient’s demographic data in Table 1. 3. We note that you have indicated that data from this study are available upon request. PLOS only allows data to be available upon request if there are legal or ethical restrictions on sharing data publicly. We uploaded our data set. Dear reviewer #1 We appreciate your immensely thorough review with positive comments and useful suggestions. We have analyzed our data and revised our manuscript according to your suggestions. The following details are our point-by-point responses to your comments. 1) Adding a schematic of the absorbance spectra the ocular media would be beneficial (cornea, lens, retina [e.g. MP and other chromophores]) to help readers understand the region of high-energy, short-wavelength light Thank you for your comment. We added figures of spectral transmission of human crystalline lenses of different age and clear and yellow-tinted IOLs. The maximum absorption wavelength of macular pigments is 460 nm and this information was added in Figure 1B. 2)The authors have correctly pointed it out but direct comparisons of RRS and 2-wavelength AF and HFP are inappropriate. Differences in measured MPOD among the 3 are difficult to assign meaning to. We consider that this comment is in response to the discussion from line 243 to 256. Both two wavelength AF and HFP measure absorbance of MP, i.e. both methods measure the same thing. Therefore, the values measured by two methods should be identical, but actually there is some difference in the absolute values, although the values by two methods show high correlation. In this discussion, we compared not the absolute values but the increase rates between our study and Nolan’s study and we think this comparison was reasonable. However, we attributed the different increase rates in two studies to the difference in the initial MP absolute values. This discussion might have some bias. Therefore, we added the following sentence in this discussion, “However, the measurement techniques used to calculate the initial MP values differed in the two studies, therefore, we should take into consideration of the difference in MP values, although the differences were thought to be minor.” 3) Please provide spectral transmission of the SN60 WF, XY1, YP2.2 and PCB00V IOLs. This might help the reader understand the absorption contribution relative to the other ocular components Thank you for your suggestion. We added the spectral transmission of clear and yellow-tinted IOLs in Figure 1B. 4) Although the author states that "No L/Z supplementation was utilized, a dietary questionnaire control might be useful Thank you for your comment. We asked the patients at the time of every examination and confirmed that they didn’t start taking supplements including lutein and zeaxanthin. We added the following sentence, “It was confirmed verbally that no patients started to take supplements containing lutein and/or zeaxanthin after surgery.” 5) Tbl 2 and 3 show that virtually all of the MPOD and MPOV values increased at every position. As MP cannot be synthesized de novo and must be obtained through diet, I'm interested to learn more about the etiology. I ask out of clinical interest because the theory posited in Lines 74-79 states that increased transmission of SW light leads to decreased MP but the theory described in Lines 233-239 state that increased retinal irradiation following cataract surgery leads to enhanced retinal capture of circulating L/Z due to increased isomerization. Should all ECCE patients be using L/Z supplementation? Thank you for your comment. The mechanisms of increase in MP after surgery is unknown. But considering the autoregulatory system of humans, this result seems reasonable. Nolan et al speculated that “the increased visible light irradiation of the retina after cataract surgery could stimulate enhanced retinal capture of circulating lutein and zeaxanthin, perhaps due to a mechanism involving increased isomerization of the MP constituents under light exposure” as described in Discussion. We have no evidences to support their speculation. We think that whether MP increase or decrease depends on the extent of increased irradiation. When the irradiation is excessive (for example, in case with clear IOL implantation), consumption of MP may be higher than MP accumulation, and MP decreases. 6) Lines 127-129 discussed analysis of RRS and MPOV @ 1.5 degrees measured through FAF. Comparison of these values may be inappropriate due to technique differences. RRS uses a different principle from AF. It measures the Raman signal of carotenoids in MP in the area of a diameter of 1 mm (= 1.6̊ ). Therefore, we compared the increase rate of MP in the similar area, i.e. MPOV within 1.5̊ eccentricity in AF and total Raman signals within 1.6̊ eccentricity. Since we compared not the absolute values but the rate of values, we consider this comparison is reasonable. Attachments Attachment Submitted filename: Response to Reviewers(PLOS).docx https://doi.org/10.1371/journal.pone.0248506.r002
1 Mar 2021 Decision Letter - Alfred S Lewin, Editor Macular pigment changes after cataract surgery with yellow-tinted intraocular lens implantation PONE-D-20-39598R1 Dear Dr. Obana, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Alfred S Lewin, Ph.D. Section Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0248506.r003
Formally Accepted
8 Mar 2021 Acceptance Letter - Alfred S Lewin, Editor PONE-D-20-39598R1 Macular pigment changes after cataract surgery with yellow-tinted intraocular lens implantation. Dear Dr. Obana: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Alfred S Lewin Section Editor PLOS ONE https://doi.org/10.1371/journal.pone.0248506.r004

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