The utility of measures of anterior segment parameters of a Pentacam Scheimpflug tomographer in discriminating high myopic astigmatism from keratoconus

Ebenezer Zaabaar; Samuel Kyei; Maame Ama Amamoah Parkson Brew; Samuel Bert Boadi-Kusi; Frank Assiamah; Kofi Asiedu

doi:10.1371/journal.pone.0260648

Peer Review History

Original SubmissionJune 25, 2021
3 Aug 2021 Decision Letter - Michael Mimouni, Editor PONE-D-21-20839 The utility of measures of anterior segment parameters of pentacam scheimpflug tomographer in discriminating high myopic astigmatism from keratoconus PLOS ONE Dear Dr. Kyei, 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 submit your revised manuscript by Sep 17 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, Michael Mimouni Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. Please provide additional details regarding participant consent. In the ethics statement in the Methods and online submission information, please ensure that you have specified what type you obtained (for instance, written or verbal, and if verbal, how it was documented and witnessed). If your study included minors, state whether you obtained consent from parents or guardians. If the need for consent was waived by the ethics committee, please include this information. 3. In the Methods section of the manuscript please additional information regarding how the participants were recruited for the study included any eligibility criteria applied. 4. You indicated that you had ethical approval for your study. In your Methods section, please ensure you have also stated whether you obtained consent from parents or guardians of the minors included in the study or whether the research ethics committee or IRB specifically waived the need for their consent. [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 Reviewer #2: Partly ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 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: No ****** 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 ****** 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 is a well written article comparing keratoconus with high myopic astigmatism based on tomography data. This is of relevance in daily practice especially in the refractive sphere. Whilst well written, I query the originality of the paper and if it adds anything new to our understanding. I would recommend a further literature search to show what is known so far to give the reader context. Furthermore, whilst the data is comprehensive, it is presented in a laboroius manner and I would consider revising the manuscript by providing a summary. Reviewer #2: dear Author most of my inquiries are from Materials and methods 1.“Patients were examined with a Scheimpflug principle-based Pentacam corneal topographer” suold be tomographer. 2.The Pentacam posses some very distinct parameters that are very specific for keratoconus and where not included in the paper: Anterior Radius of Curvature (ARC) Posterior Radius of Curvature (PRC) and on the BAD display Df,Db,Dp,Dt,De, BAD-D which were validated by Beilin and Ambrosio’s work and makes them the “go to” parameters to distinguish normal from keratoconus cornea when using the Pentacam 3.Way the particular parameters where chosen? 4.How was high myopic astigmatic patient were defined in diopters? And was the astigmatism matched to KC patients? 5.No details on inclusion and exclusion criteria like corneal interventions, use of contact lens and proper contact lens discontinuation before Pentacam scans etc. 6.Was there any randomization in choosing the patients in both groups ? ****** 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 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. https://doi.org/10.1371/journal.pone.0260648.r001
Revision 1
28 Aug 2021 Author Response COMMENTS OF ACADEMIC EDITOR COMMENT “Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming.” RESPONSE Thank you. The suggested corrections are valid. The manuscript has been edited in the reference section to meet PLOS ONE’s style requirements and files have been named as requested. See red highlights on lines 287-373 of pages 16-20. COMMENT “Please provide additional details regarding participant consent. In the ethics statement in the Methods and online submission information, please ensure that you have specified what type you obtained (for instance, written or verbal, and if verbal, how it was documented and witnessed). If your study included minors, state whether you obtained consent from parents or guardians. If the need for consent was waived by the ethics committee, please include this information.” RESPONSE We are very grateful for the academic editor’s constructive comment. We are sorry for the unfortunate mix up and the oversight of stating that the study employed a prospective design. The study rather used a retrospective design and covered a 7-year period from January 2014 to December, 2020. We are actually working on multiple articles that are based on similar datasets collected from the same facilities. Thus, the articles have got practically the same methods except that some are retrospective whereas others are prospective. We are sorry to say that there was a mix up of the methods of the current study protocol with that of another, and we assume responsibility for that and extend our apology. However, it is readily evident and can be confirmed from the discussion of our first submission that the current study is really retrospective as we stated the retrospective and non-randomized design of the study as a limitation. This statement has been highlighted in blue for ease of reference. Since medical records were reviewed retrospectively and identifying particulars of patients’ details concealed, patients’ consents were not needed for the study and were therefore waived by the IRB. Thank you so much for critical review which brought to bear this mix up. See red highlights on lines 92-99 of page 5 and on lines 271-272 of page 15. COMMENT “In the Methods section of the manuscript please additional information regarding how the participants were recruited for the study included any eligibility criteria applied.” RESPONSE Thank you. Since the study was retrospective and involved reviewing of medical records of already existing cases, there was no recruitment of subjects. See highlights on lines 92-99 of page 5. COMMENT “You indicated that you had ethical approval for your study. In your Methods section, please ensure you have also stated whether you obtained consent from parents or guardians of the minors included in the study or whether the research ethics committee or IRB specifically waived the need for their consent.” RESPONSE Thank you. Since medical records were reviewed retrospectively and identifying particulars of patients’ details concealed, patients’ consents were not needed for the study and were therefore waived by the IRB. See red highlight on page 5, lines 92-99. COMMENT OF REVIEWER 1 “This is a well written article comparing keratoconus with high myopic astigmatism based on tomography data. This is of relevance in daily practice especially in the refractive sphere. Whilst well written, I query the originality of the paper and if it adds anything new to our understanding. I would recommend a further literature search to show what is known so far to give the reader context. Furthermore, whilst the data is comprehensive, it is presented in a laboroius manner and I would consider revising the manuscript by providing a summary.” RESPONSE Thank you. A further literature search has been conducted to show what is known so far to provide the reader with context. Also, even though the data appear too elaborate, it was presented in a manner that would enable easy comparison with similar studies, many of which presented their data in an equal fashion. (reference numbers 15, 18, 20, 22, 32). Besides, the tables have been split to form five tables with independent table headings. See highlighted changes on pages 3-4. Lines 53-78. Also see red highlights on lines 321, 329, 335, 340 and 368 of pages 18 and 20. COMMENT OF REVIEWER 2 dear Author most of my inquiries are from Materials and methods “Patients were examined with a Scheimpflug principle-based Pentacam corneal topographer” suold be tomographer. RESPONSE Thank you. “topographer” has been replaced with “tomographer” in the Materials and methods section. Kindly see highlighted changes on lines 109-110 of page 5. COMMENT ‘The Pentacam posses some very distinct parameters that are very specific for keratoconus and where not included in the paper: Anterior Radius of Curvature (ARC) Posterior Radius of Curvature (PRC) and on the BAD display Df,Db,Dp,Dt,De, BAD-D which were validated by Beilin and Ambrosio’s work and makes them the “go to” parameters to distinguish normal from keratoconus cornea when using the Pentacam’ RESPONSE Thank you. All the parameters you have drawn our attention to were actually included in the results section and written about in the discussion section of the main manuscript as well as in the abstract. Kindly see red highlights on tables 1, 2, 4 and 5 of pages 8, 9, 10, 11 and 12. Also see red highlights on lines 264-271 of page 15. COMMENT “Way the particular parameters where chosen?” RESPONSE Thank you very much. All chosen parameters were informed by literature and related studies. COMMENT “How was high myopic astigmatic patient were defined in diopters? And was the astigmatism matched to KC patients?” RESPONSE Thank you. This is a valid question. Patients who had sphero-cylindrical refractive errors with spherical components greater than -6.00D were considered high myopic astigmats. Besides, because keratoconus induces high and irregular astigmatism, it was difficult getting high myopic astigmats with matched cylinder components. However, cases in both groups were age matched. See highlighted changes on lines 135-137 of page 7. COMMENT “No details on inclusion and exclusion criteria like corneal interventions, use of contact lens and proper contact lens discontinuation before Pentacam scans etc.” RESPONSE Thank you. Inclusion and exclusion criteria have been expanded to include details on contact lens wear and corneal interventions prior to Pentacam scans. See highlighted changes on lines 104-108 of page 5. COMMENT “Was there any randomization in choosing the patients in both groups?” RESPONSE Thank you. The study employed a retrospective cross-sectional design and did not require random assignment of participants. See red highlights on lines 92-99 of page 5. Attachments Attachment Submitted filename: Response to Reviewers 2.docx https://doi.org/10.1371/journal.pone.0260648.r002
15 Nov 2021 Decision Letter - Michael Mimouni, Editor The utility of measures of anterior segment parameters of pentacam scheimpflug tomographer in discriminating high myopic astigmatism from keratoconus PONE-D-21-20839R1 Dear Dr. Kyei, 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, Michael Mimouni Academic Editor PLOS ONE Additional Editor Comments (optional): 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: All comments have been addressed ******** 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: Yes ****** 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: The authors have adequately responded to the issues raised in the previous review. This is a relevant paper which the readership will find useful. Reviewer #2: Dear Author, I appreciate your dedicated and thorough response. you addressed all of my questions and modified the the paper accordingly. ****** 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 https://doi.org/10.1371/journal.pone.0260648.r003
Formally Accepted
17 Nov 2021 Acceptance Letter - Michael Mimouni, Editor PONE-D-21-20839R1 The utility of measures of anterior segment parameters of a Pentacam Scheimpflug tomographer in discriminating high myopic astigmatism from keratoconus Dear Dr. Kyei: 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. Michael Mimouni Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0260648.r004

Open letter on the publication of peer review reports

PLOS recognizes the benefits of transparency in the peer review process. Therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. Reviewers remain anonymous, unless they choose to reveal their names.

We encourage other journals to join us in this initiative. We hope that our action inspires the community, including researchers, research funders, and research institutions, to recognize the benefits of published peer review reports for all parts of the research system.

Learn more at ASAPbio .