3-D cephalometry of the the orbit regarding endocrine orbitopathy, exophthalmos, and sex

Konstantin Volker Hierl; Matthias Krause; Daniel Kruber; Ina Sterker

doi:10.1371/journal.pone.0265324

Peer Review History

Original SubmissionOctober 17, 2021
10 Dec 2021 Decision Letter - Kapil Amgain, Editor PONE-D-21-332223-D cephalometry of the the orbit regarding endocrine orbitopathy (EO), exophthalmos, and sexPLOS ONE Dear Dr. Hierl, 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. ==============================Dear Author,Please go through the feedback and upload the revised file as per feedbackThank you ============================== Please submit your revised manuscript by Jan 24 2022 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. 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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 (1) whether consent was informed and (2) 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. If you are reporting a retrospective study of medical records or archived samples, please ensure that you have discussed whether all data were fully anonymized before you accessed them and/or whether the IRB or ethics committee waived the requirement for informed consent. If patients provided informed written consent to have data from their medical records used in research, please include this information. [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: Partly Reviewer #2: Yes ******** 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: Yes ****** 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: The author’s work is appreciated but it would have been better if they incorporate these suggestions to make this manuscript even better. 1. Please remove the short form (EO) from the title as full form is already mentioned, if possible. 2. In abstract section, please do not start the sentence with number rather start with words like- ‘two’ instead of ‘2’. Please make the conclusion part concise and short. 3. Title in the beginning and in the main manuscript is different. Please calrify. 4. Please mention the objective of this study at the end of ‘introduction part’ after it’s rationale. 5. Out of 123 samples, 71 were having no known pathology, doesn’t it raise the ethical concern for radiation exposure while doing CT? Please defend this. 6. Please mention your own findings only in the result section. 7. In discussion, please try not to repeat the result findings again if it's not applicable for discussion with other literatures and also you can remove the reference table and figures from the discussion as it’s already there in the results. 8. There is inadequate discussion on the interpretation and implication of study findings. It would have been better if they have included more comparable studies on discussion. 9. Please correct some grammatical error in the manuscript. 10. Please write the conclusion part in short, clear and concise. Reviewer #2: Portions of the results section have been placed in the methods section. The method section basically focus on the research design, how the study was conducted and how the reader who wants to do the similar study can reproduce the method in this paper ****** 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. Attachments Attachment Submitted filename: PONE-D-21-33222.pdf https://doi.org/10.1371/journal.pone.0265324.r001
Revision 1
5 Jan 2022 Author Response Dear Mr Amgain, dear reviewers, Thank you very much for your comments to improve the quality of the submitted paper draft. In the following chapters, all remarks will be covered and the text changes marked appropriately in the paper and in this document. Remarks by the editor: 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 This has been done. 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 (1) whether consent was informed and (2) 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. If you are reporting a retrospective study of medical records or archived samples, please ensure that you have discussed whether all data were fully anonymized before you accessed them and/or whether the IRB or ethics committee waived the requirement for informed consent. If patients provided informed written consent to have data from their medical records used in research, please include this information. This study has been a retrospective investigation on medical records. The local University ethics commission waived the requirement of informed consent as pseudonymization of all data was performed. Thus the following sentence was included on p. 10 at the end of the Materials and methods section (highlighted in green): This retrospective study was approved by the local Leipzig University ethics commission (No. 285-14-25082014) and followed the Declaration of Helsinki on medical protocols and ethics. As pseudonymization of the CT data was performed, the requirement of informed consent was waived by the ethics committee. Reviewer’s 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 author’s work is appreciated but it would have been better if they incorporate these suggestions to make this manuscript even better. 1. Please remove the short form (EO) from the title as full form is already mentioned, if possible. The short form (EO) was removed from the title. 2. In abstract section, please do not start the sentence with number rather start with words like- ‘two’ instead of ‘2’. Please make the conclusion part concise and short. 2 was changed to as required: …and without EO. Two out of 12 angles showed a statistically …. The conclusion was shortened made more focused. The changes were (added: light blue, deleted words: red): There appears to be In this study little difference in orbital anatomy between patients with and without EO was found…. Thus, orbital anatomy is likely to be of minor relevance in the etiology of EO but may influence therapy regarding timing and surgical procedures as orbital rim anatomy it affects exophthalmos. Sex-based differences were confirmed. 3. Title in the beginning and in the main manuscript is different. Please clarify. As the title fulfills the word count requirements of the short title, the short title was changed to the full title. 4. Please mention the objective of this study at the end of ‘introduction part’ after it’s rationale. The objectives of our investigation have now been summarized at the end of the introduction. The changes are: … The purpose of our study was to evaluate orbital anatomy in patients with and without EO investigating the relevance of orbital anatomy in the etiology of EO and exophthalmos – one of its major clinical features – using a new approach of three-dimensional cephalometric measurement. In previous investigations Utilizing measurements in CT-scans, Baujat et al. and Rajabi et al. [8, 9] did not find such significant anatomical differences in EO patients besides slight differences in the lateral orbital angle (angle between the midsagittal plane and the lateral orbital wall) or interorbital distance. These studies, however, were limited by several factors like the use of axial CT slices for 2-D measurements instead of 3-D cephalometry [8, 9]. Baujat et al. compared two patient groups with exophthalmos (EO and non-EO) [8] whereas Rajabi et al. evaluated a small groups of non-EO patients [9]. The number of observed parameters was limited in both evaluations. Moreover, the influence of sex was not evaluated. Thus, the purpose of our study was to evaluate orbital anatomy in patients with and without EO investigating the relevance of orbital anatomy in the etiology of EO and exophthalmos – one of its major clinical features – using a new approach of three-dimensional cephalometric measurement. 5. Out of 123 samples, 71 were having no known pathology, doesn’t it raise the ethical concern for radiation exposure while doing CT? Please defend this. The control CTs without anatomical discernable pathology had been acquired because of the following reasons: search for foci in the head & neck region due to general illnesses (but none found), search for anatomical causes of neurologic disorders (none found), CT scans in preparation of oral surgery/oral maxillofacial surgery which didn´t cause anatomical alterations with regard to this investigation (e.g. wisdom teeth removal) The following sentence was added in Materials and methods section: …group. The CT scans without anatomical discernable pathology (reference group) had been acquired in search for foci in the head & neck region due to general illnesses, in search for anatomical causes of neurologic disorders, and in preparation of oral surgery or oral and maxillofacial surgery not associated with anatomical alterations relevant to this investigation. Besides… 6. Please mention your own findings only in the result section. The results regarding symmetry which had been repeated in the discussion were deleted. The text was changed to: …Generally, the orbital anatomy was highly symmetrical with an average side difference in distances of 0.3 mm and an average side difference in angles of 0.6° Regarding symmetry, the differences in this investigation were which is clinically… 7. In discussion, please try not to repeat the result findings again if it's not applicable for discussion with other literatures and also you can remove the reference table and figures from the discussion as it’s already there in the results. Both tables in the discussion section have been changed to only display reference data. Repetitions of our results were removed from the discussion section. 8. There is inadequate discussion on the interpretation and implication of study findings. It would have been better if they have included more comparable studies on discussion. Within the discussion section, some aspects have now been treated more in depth. This includes methodology: - 3D cepalometry per se (p. 16-17) and results: - 3D symmetry (p. 18-19) - 3D anatomy (p. 20-21) - sex differences (p. 23-24) - importance of orbital rim morphology (p. 24-26) - importance for surgical treatment (p. 27) More literature was included in the discussion (see references marked in blue) 9. Please correct some grammatical error in the manuscript. Grammar errors have been deleted and style was improved. 10. Please write the conclusion part in short, clear and concise. The conclusion was changed to be more concise and clear. Reviewer #2: Portions of the results section have been placed in the methods section. The method section basically focus on the research design, how the study was conducted and how the reader who wants to do the similar study can reproduce the method in this paper The materials and methods chapter was checked to include no results. Only data on the patient and control group was provided. Furthermore, only the lists of the utilized landmarks and the measured distances and angles have been presented. Concerning data presentation in the discussion (see reviewer 1/6 & 7), this has be changed. Attachments Attachment Submitted filename: Revision notes to journal.docx https://doi.org/10.1371/journal.pone.0265324.r002
18 Jan 2022 Decision Letter - Kapil Amgain, Editor PONE-D-21-33222R13-D cephalometry of the the orbit regarding endocrine orbitopathy, exophthalmos, and sexPLOS ONE Dear Dr. Hierl, 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 Mar 04 2022 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: https://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, Kapil Amgain Academic Editor PLOS ONE Dear Author, Please find the attached feedback file and revise the manuscript as per the comments. [Note: HTML markup is below. Please do not edit.] [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.0265324.r003
Revision 2
5 Feb 2022 Author Response The following text states the changes made according to the reviewer’s suggestions. Changes are highlighted in yellow. Changes requested by both reviewers were not independently highlighted. Title page 3-D cephalometry of the the orbit in patients with and without endocrine orbitopathy (EO). Which is the orginal title of study? Two titles were initially given as a secondary short title was requested. As the original title did not exceed the word count of the short title, the short title was changed to the main title. It is better to aviod abbreviations in title of study in such way? The abbreviation was deleted Abstract What was the study design? Which statistical software and tools were used to analyze the data? Information was added in the “methods” chapter of the abstract: … Orbital anatomy of 123 Caucasian patients (52 with EO, 71 without EO) was examined using computed tomographic data and FAT software for 3-D cephalometry. Using 56 anatomical landmarks, 20 angles and 155 distances were measured. MEDAS software was used for performing connected and unconnected t-tests and Spearman´s rank correlation test to evaluate interrelations and differences. … Main text Grammar and typing errors were corrected Materials and Methods The methodology was started with the study design as suggested. The highlighted passages regarding patient data were transferred to the results section. References The capitalization of titles was changed from the respective journal style to PLOS reference style. The title of reference 5 was not changed as capitalization of nouns is standard German grammar. Attachments Attachment Submitted filename: Covering Letter References to table 1-8.docx https://doi.org/10.1371/journal.pone.0265324.r004
1 Mar 2022 Decision Letter - Kapil Amgain, Editor 3-D cephalometry of the the orbit regarding endocrine orbitopathy, exophthalmos, and sex PONE-D-21-33222R2 Dear Dr. Hierl, 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, Dr. Kapil Amgain Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0265324.r005
Formally Accepted
4 Mar 2022 Acceptance Letter - Kapil Amgain, Editor PONE-D-21-33222R2 3-D cephalometry of the the orbit regarding endocrine orbitopathy, exophthalmos, and sex Dear Dr. Hierl: 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. Kapil Amgain Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0265324.r006

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