PONE-D-21-08524

Exploring the effects of degraded vision on sensorimotor performance

PLOS ONE

Dear Dr. Sheppard,

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.

Two expert reviewers have assessed your work. Both find your study interesting and well executed, and provide several constructive points of discussion that should be added to your manuscript. Both reviewers also ask for some clarifications and Reviewer 1 in particular points out several missing methodological details that should be included in the manuscript. Overall, I think it should straightforward to address all reviewer comments, so I look forward to receiving the revised version of this interesting work.

As an additional note, you may find [Maiello et al 2018] relevant to your work and perhaps useful for addressing some reviewer comments (e.g. comment 7 from Reviewer 1). I wish to stress however that I am not asking you to cite this paper I have authored, you should do so only if you find that it improves your manuscript, and this will have no bearing on my final decision.

Maiello, G., Kwon, M., & Bex, P. J. (2018). Three-dimensional binocular eye–hand coordination in normal vision and with simulated visual impairment. Experimental Brain Research, 236(3), 691-709.

Please submit your revised manuscript by Jul 29 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

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If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

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We look forward to receiving your revised manuscript.

Kind regards,

Guido Maiello

Academic Editor

PLOS ONE

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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

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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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: This study examined the effect of impaired vision on the performance of several motor tasks: aiming, pegboard, and water pouring in Exp 1, and aiming, tracking and steering in Exp 2. The goal in experiment 1 was to assess the effects of degraded binocular vision while experiment 2 compared performance during binocular and monocular viewing. This is an interesting study with a large cohort of young participants which provides some insight into how short term disruption in vision affects motor performance. The study is well motivated, the design and analysis are appropriate; however, I have a few comments for the authors to consider to improve their paper.

Experiment 1

1. Provide more details about the method used to select the Bangerter filters. Did all participants wear the same strength of the filter such that VA was ~0.3 logMAR? If there was a range of filters used, provide the details (mean, std dev, range). This could be summarized in a Table. In case the same filter was used, its effect on VA, CS and stereo could also be summarized in a Table (ie report the mean, std dev and range) or present the distributions using a boxplot rather than just the mean and std dev which is currently plotted in Fig 2.

2. In Fig 2 mean stereoacuity in no impairment condition is ~100 arc sec which seems too high in a cohort of visually healthy young individuals. I would expect 40 arc sec based on the clinical test, please explain

3. Was there only one trial per visual condition for the water pouring and pegboard tasks? Were participants allowed to practice the task before data collection?

4. Was performance on the water pouring task measured with a stopwatch to the nearest tenth or hundredth of a second?

5. Please provide a more detailed description of the aiming task: what were the instructions: speed, accuracy or both? what was the distance between the dots? The size of the dots? Duration of the interstimulus interval? Sampling rate? The authors mentioned ‘several kinematic measures’ on Line 238 but only one measure is defined in this section, that is ‘movement time’ – based on the definition provided, it sounds like the measure is ‘response time’ rather than ‘movement time’, please clarify. Was accuracy also quantified?

6. Paragraph on lines 369-376. This paragraph implies that reaching performance is significantly impaired by induced blur, however, deficits in reaching have not been reported in ref 55, that study found differences in secondary saccades. Also, if water pouring performance is affected it’s probably due to difficulty in seeing the marking on the beaker that needs to be filled with water rather than increased uncertainty in the position of the hand (proprioception provides input about the position and movement of the hand)

Experiment 2

7. The authors should provide a more compelling case for selecting a binocular vs monocular viewing rather than the three viewing conditions studied in experiment 1. Given the findings in experiment 1, why were the same conditions not studied for the tracking and steering tasks? The logical link between experiment 1 and 2 is missing. There is an extensive literature that compared motor performance on various tasks during binocular and monocular viewing that has not been mentioned at all. Are the tasks studied here unique and provide additional insight about the contribution of binocular vision to feedforward and feedback control? The authors should explain why they expect that ‘monocular viewing creates lags in the online feedback system’ - line 413.

8. Please provide more details for the tracking stimulus: size of the moving circle, speed, size of the stimulus (ie figure 8 path)

9. Was there a practice trial for any of the tasks?

10. I think that presenting the pPA measure is not sufficient, it is very hard to interpret this score (unless the reliability and validity of using this score has been established in previous published work - please provide a reference). Was the path accuracy quantified using RMSE? Please present the spatial and temporal accuracy scores separately to facilitate interpretation.

11. Why was the left eye assigned as the better eye in cases of equal VA rather than using a test to determine the preferred eye (as was done in exp 1)?

12. In the legend of Fig 7 the authors suggest that ‘fatigue’ contributed to poorer performance on the ‘with guide’ condition at the fastest speed. This task was done first and the whole protocol is <15 min, why would fatigue have such a large effect on this task condition? What is contributing to the fatigue? I doubt it’s muscle fatigue. Perhaps there is an alternative explanation

13. Additional analysis was conducted by excluding participants with reduced VA (n=16) or IOD greater than 0.2 (n=11), rather than excluding the data, consider presenting the means for the different groups in a Table or running an exploratory sub-analysis to compare the performance of the individuals grouped by VA. Or perhaps a regression analysis would provide some insight into the contribution of VA to motor performance during binocular or monocular viewing.

14. Why do aiming and steering tasks require fast online corrections (Line 608)? Is there any evidence in this study supporting this interpretation? Lines 248-250 mention that the last 25 aiming trials have a jumping target, and that these trials were excluded from the analysis. If the authors are interested in fast online corrections, analysis of these trials would actually provide some insight into that question.

15. Perhaps the argument starting on Line 620 could be presented more clearly, when performance declined during monocular viewing it’s due to the poor acuity in that the viewing eye rather than the IOD?

16. Paragraph starting on line 640 acknowledges the limitations of the current study and suggest that kinematics could provide more insight into motor performance which may provide some advantages for clinical assessments. In general, I agree with the authors, but it’s important to also acknowledge that the subset of tasks used in this study is quite limited, only planar movements on a tablet, most of daily activities require interacting with objects in a 3D world. Also, there are many other ‘sophisticated kinematic measures’ – it might be worthwhile to provide a brief discussion of why the selected measures were chosen.

Minor comments

Please proof read and correct grammatical and syntax errors.

Line 227: clarify what ‘incorrectly placed pins’ refers to, were these pins dropped? Or placed in the wrong hole?

Figures should be numbered in the order of appearance, in the current manuscript Fig 6 is referred to first on Line 231. Please provide a more detailed description of the aiming task: what were the instructions: speed, accuracy or both? what was the distance between the dots? The size of the dots? Duration of the interstimulus interval? The authors mentioned ‘several kinematic measures’ on Line 238 but only one measure is defined in this section, that is ‘movement time’ – based on the definition provided, it sounds like the measure is ‘response time’ rather than ‘movement time’, please clarify. Was accuracy also quantified?

Figure 1: correct the order of steps: currently Step 5 comes after Step 1

Reviewer #2: The authors present a well written manuscript examining the effects

of degraded monocular on a series of visual tasks. The demonstrated several

effects comparing monocular vs. binocular viewing conditions and best eye vs. worst eye,

showing that degraded monocular vision usually impairs performance.

The manuscript is well presented, my primary request would be for the authors

to provide motivation in the introduction for studying young people with normal vision

as the mansuscript seems to initially be focused on how this may impact visual impairments

in older individuals might impact quality of life. The results show that even in this healthy

population deficits are often apparent so it stands to reason these may generalise

to an older population with actual visual problems (although as mentioned in the discussion this

may be overcome to some degree with training), further it would be interesting to have same age

comparisons with people who are stereo blind (for another study but worth mentioning in dicussion)

L65 what is the functional impact of "a" unilateral visual deficit?

L144 capitalize name "Purdue Pegboard Task"

L197 delete repeated "consisted of"

L210 do you mean participants who correctly identified just 1 circle and

not "the 1 correct"?

Could you add asterisks highlighting the significant comparisions in the charts

presented in Figures 2-5, 8

L412 what about rivalry? Perhaps performance is made worse due to this.

I am not sure what you mean by creating lag can you be more specific.

For example, rivalry might cause uncertainty about

stimulus location which might slow movements. Is there another mechanism you are thinking of?

Perhaps that binocolar summationgenerates a stronger neural signal that might be

processed faster - can you cite prior research backing this idea?

L431 - Particpants weren't compensated? Were they given course credit please clarify?

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Reviewer #1: No

Reviewer #2: 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.]

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PONE-D-21-08524R1

Exploring the effects of degraded vision on sensorimotor performance

PLOS ONE

Dear Dr. Sheppard,

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.

Both reviewers were satisfied with your revisions. Reviewer 2 has a few remaining comments that should be straightforward to address. Regarding your data availability, I can see and correctly access your github link, so no action is necessary, but you may still wish to highlight your dataset by directly referencing it in your main manuscript text. 

Please submit your revised manuscript by Oct 04 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Guido Maiello

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: (No Response)

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2. 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

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: No

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

6. 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: (No Response)

Reviewer #2: Thanks for the revised MS. Overall, I am satisfied with the state of things but have a few small requests.

Also, as far as I could see the manuscript does not include a reference or link to

where the open data can be accessed - I may be in error but please make sure this

is present to meet the PlosOne open data policy

L239 - Please list average estimated visual angle and distance of viewer to the tablet screen.

L235 - PLease clairfy in text and caption that participants only do the aiming task

in Exp 1 and that the other tasks are relevant to Exp 2

L272 - please clarify - I think you mean to say:

All baseline tests for performance with full vision

baseline were recorded first for each participant with no time alloted

for practice as the conditions are easily learned. After baseline recordings,

conditions with simulated visual impairments were counterbalanced.

L335 Is there a need to present the interaction between speed & accuracy?

The findings make sense but I'm not sure what it illustrates that aren't already

evident in Figure 4A & 4B? I'm fine either way but if the authors prefer to keep

can you add a sentence or two highlighting why this is useful and what it adds beyond

time and accuracy alone.

L389 The accuracy x time interaction is mentioned again and it is mentioned as novel

but with no further description of its utility - Please to add some justification

on why it is useful beyond considering time and accuracy alone,

Else please omit as described above.

L473 - Please state the average and std.dev. of the difference between worst and best eye and the sd?

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7. 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

Reviewer #2: 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.

Exploring the effects of degraded vision on sensorimotor performance

PONE-D-21-08524R2

Dear Dr. Sheppard,

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.

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Kind regards,

Guido Maiello

Academic Editor

PLOS ONE

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