PONE-D-22-06589Correlation between Clinical Presentations, Radiological Findings and High Risk Histopathological Features of Primary Enucleated Eyes with Retinoblastoma at Queen Sirikit National Institute of Child Health: 5 years resultPLOS ONE

Dear Dr. Wangtiraumnuay,

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ACADEMIC EDITOR:The manuscript needs some grammatical and style revision. Some sections of the manuscript are redundant and can trimmed. The authors should also focus in the discussion on the significance of their findings.

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Ahmed Awadein, MD, Ph.D, FRCS

Academic Editor

PLOS ONE

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Reviewers' comments:

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Comments to the Author

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Reviewer #1: Partly

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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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: No

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: Although there are many previous similar reports , which have described the high risk histopathological features after enucleation and yielded more or less similar results and conclusions, your study analyzed added the analysis of the correlation with radiological findings and clinical presentation.

1/3 of your included patients (11 out of 33) did CT ONLY as the imaging modality prior to enucleation. Apart from the fact you already mentioned in your introduction that the high dose of ionizing radiation used in CT should be avoided and carries a high risk in hereditary cases, MRI is definitely the scan of choice for detection of ON, choroid &/or scleral involvement. So you relied on a relatively less accurate test in 33% of your patients for the analysis of the radiological findings and its correlation with HP and clinical findings.

The "Introduction" section is redundant and would be better summarized.

The English in the manuscript is not of publication quality and require major improvement and proof-reading.

Reviewer #2: The manuscript has been drafted with great efforts. I appreciate the hard-work put in by the team.

1. As there was an association seen between age and high-risk factors in the study, it will be interesting to have the p-value for the same as a part of the abstract too.

2. The conclusion section of the abstract has a blend of results and conclusion. It will be great if the authors could segregate the same.

3. I think it will be a better idea to include the word "advanced retinoblastoma" as a part of the title too.

4. The introduction has been written very well with appropriate information for the readers.

5. Line 135-136 - Advanced retinoblastoma term followed by grouping, shall cover the spectrum neatly. Kindly reconsider the terms used here. Or are all the groups included? It is slightly unclear here.

6. Line 137 - Was it a consecutive enrollment? If yes, please mention the same.

7. Line 143 - Was the chemotherapy given monthly or 2-monthly? Kindly highlight.

8. Line 145 - Was it just high IOP or NVG?

9. Table 2 - Inclusion of high IOP along with proptosis seems a little inaccurate. Best to cover NVG separately.

10. Line 153 - Please mention the number. As all the cases weren't group E.

11. Table 3 - It will be interesting if the authors could include the histopathological risk factors in the table and compare with the radiological findings. A reflection of the same gives a higher impact. It has been partly covered in table 6, but it will be best if combined while commenting on all the variables.

12. Line 190 - Highlighting again that proptosis and glaucoma are best if individually assessed and commented upon.

13. Kindly keep the percentage format symmetrical throughout the manuscript i.e. rounded to one decimal or 2 decimals or none.

14. Line 232 - 233 - Kindly cite the reference here.

15. Line 247 - A brief comment on the conclusion of the study is recommended.

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Reviewer #1: No

Reviewer #2: No

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Correlation between clinical presentations, radiological findings and high risk histopathological features of primary enucleated eyes with advanced retinoblastoma at Queen Sirikit National Institute of Child Health: 5 years result

PONE-D-22-06589R1

Dear Dr. Wangtiraumnuay,

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.

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Kind regards,

Ahmed Awadein, MD, Ph.D, FRCS

Academic Editor

PLOS ONE

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Reviewers' comments: