PONE-D-22-24932Prevalence and nature of self-reported visual complaints in people with Parkinson’s disease - Use of the Screening Visual Complaints questionnairePLOS ONE

Dear Dr. van der Lijn,

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 Nov 21 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.

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• 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,

Thiago Fernandes, Sp. Neuro, EbS, PhD

Academic Editor

PLOS ONE

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2. We noted in your submission details that a portion of your manuscript may have been presented or published elsewhere. 

" Parts of the same data were used for publication of our research article "The Screening Visual Complaints questionnaire (SVCq) in people with Parkinson’s disease - Confirmatory factor analysis and advice for its use in clinical practice". This does not constitute dual publication, since the earlier publication focused on the validation and use of the questionnaire in a clinical population. In contrast, the current submission uses the questionnaire scores of people with Parkinson's disease with the aim of providing insight into the prevalence of their visual complaints and contributing risk factors."

Please clarify whether this [conference proceeding or publication] was peer-reviewed and formally published. If this work was previously peer-reviewed and published, in the cover letter please provide the reason that this work does not constitute dual publication and should be included in the current manuscript.

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Additional Editor Comments:

Reviewers have now commented on your study. You will see that we require some amendments to be made before we are able to proceed. 

If you are prepared to undertake the work required, I would be pleased to forward for publication. For your guidance, reviewers' comments are appended below. 

Most of the comments were very quick-to-solve and, overall, we find your study very interesting. You also will notice that some of the comments are really specific, so please be cautious when arguing & making the necessary amendments. 

Please respond to the Reviewer's comments in a separate letter AND highlight all changes in the manuscript. 

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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

Reviewer #3: Yes

Reviewer #4: Partly

Reviewer #5: Partly

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

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

Reviewer #4: Yes

Reviewer #5: 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

Reviewer #3: Yes

Reviewer #4: Yes

Reviewer #5: 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

Reviewer #3: Yes

Reviewer #4: Yes

Reviewer #5: 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: The fact that visual complaints cannot be fully explained by ophthalmological conditions is not a surprise. Several diseases affecting the central nervous system cause visual disturbances that cannot be detected during the standard ocular and visual examinations. Therefore, research addressing visually guided behaviors and self-reported visual performance is quite relevant in patients with progressive diseases affecting the brain,

It was interesting to learn from the Authors that PD patients are at high risk of visual complaints such as trouble to reading and focusing. These alterations are likely associated, at least partially, with oculomotor impairments since other visual attributes that may be less dependent on precise fixational eye movements, such as visual field and color vision, showed much lower prevalence.

I would like to congratulate the Authors for their great work and well-organized report. I recommend to include in the discussion a brief description concerning the above-mentioned possible associations between visual disturbances and oculomotor alterations in PD patients that may be a subject of future investigations.

Reviewer #2: The study entitled "Prevalence and nature of self-reported visual complaints in people with Parkinson’s

disease - Use of the Screening Visual Complaints questionnaire" is well executed. The authors have made a clear investigation and have prepared the questionnaires to include most common visual defects for early diagnosis among PD patients. However, the authors need to clarify few aspects,

1. In the introduction the authors can write more about the visual defects that are reported among PD patients with relevance to their stage of PD

2. Whether any subsequent ophthalmic examinations were carried out on the self-reported patients to confirm the nature of the visual condition, like assessing their visual acuity to further confirm ? unclear vision appears to be a pre-dominant complaint with 23.2% reporting, so having a simple visual acuity test on these patients would have added more value to the data.

3. Did the authors consider analyzing the data from PD cases based on their stage of the disease apart from classifying based on their age, if so how was the correlation between the visual condition and stages ? This would provide some insight on the ophthalmic deterioration with relevance to the severity of the PD.

4. How the co-morbidity of diabetes among the PD cases were considered ? and does the control group contains diabetes cases ?

5. The authors need to clarify how many of the PD cases reported here were under dopaminergic medication and also of the total PD cases reported how many were freshly identified to have PD and without taking any dopaminergic medication ?

6. Also it would be nice to record the sleep patterns of the PD patients especially those undergoing dopaminergic treatment and correlate with the visual condition ?

Reviewer #3: The manuscript reports an investigation of visual complaints in a population of Parkinson Disease's patients and compared to age-matched controls. I have some minor points to improve the manuscript's quality.

Abstract

Please indicate the numerical prevalence in the results.

Introduction

The Introduction is short, I suggest a paragraph fastly citing the more important or known visual complaints. It would be informative for a general audience.

Methods

Was there some information about the socioeconomic profile from PD patients and controls? If not, include as limitation.

Results

Figure 1 has no legend in the Y- and X- axis, and the numbers have low contrast. I suggest to include the legends and paint in black the numbers and letters. Why is not indicated the statistical difference?

Discussion

-The methods of data collection in PD patients and controls were different and it is an limitation of the study. The authors should discuss about it.

Reviewer #4: 1. The title can be “Prevalence and …….. - Screening Visual Complaints questionnaire outcome” or "outcome of SV...Q"; instead of “Use of the Screening Visual Complaints questionnaire”.

2. Line 69, please define mild, severe, and moderate condition staging.

3. Your control group had mild PD (line 67)? How is that not affecting your comparison with those having PD?

4. “Dutch-speaking people were invited” implies they can be of any ethnicity speaking dutch. Is ethnicity a factor affecting PD? (DOI: 10.3233/JPD-191763)

5. Are your study participants “people” or are they “patients” of the center?

6. Line 154, mentioning Evdk as a research assistant is unnecessary. “Two researchers” is enough.

7. The authors themselves published a systematic review of “Self-reported visual complaints in PD” in 2022 (DOI: 10.3233/JPD-202324). Moreover, the svc questionnaire you have used is an existing one (with a similar sample size and control group DOI: 10.1371/journal.pone.0272559), used previously and the results are in the systematic review itself. Please explain in detail the need for this study and what additional this study is achieving, that others could not before using the same questionnaire. Basically, how did you overcome the limitations of previous studies (if any).

8. Line 84-85, “In addition, a clear and clinically relevant factor structure has been demonstrated in people with PD” is unclear, please restructure.

9. Although PD patients were previously diagnosed and taken from medical files, please explain the diagnostic criteria of PD and staging and also for the control group.

10. Please explain in detail the ophthalmological examination conducted on the PD and control group.

11. Including people both with and without cataract surgery in the PD and control group, are you introducing any kind of bias or not? (Although you have mentioned excluding them did not alter the results). Please discuss this.

12. Conclusion: “Since visual complaints can have a vast impact on the daily lives of people with PD” Have you tested the QOL in people with PD in this study? Either add a reference or remove the line.

13. Tables 7 and 8 look unnecessary. Adding results is enough.

Reviewer #5: Prevalence and nature of self-reported visual complaints in people with Parkinson’s disease- Use of the Screening of Visual Complaints questionnaire

This paper describes the prevalence of visual complaints in people with PD compared to a healthy control group. This subject is relevant and interesting. It deserves more attention in both research and clinical practice, and I agree with standardized screening for ophthalmological problems and disorders However, I do have a few questions and suggestions that may improve the contribution.

- First, I think both the introduction and discussion need some work. It is clear that this is an underrecognized topic and in need of more study. However, I think that these sections lack a good representation of the work that has already been performed on this subject. The introduction should, in addition, also indicate what this study adds to the current literature.

What is truly new (in my opinion tables 5-8) and how could this help to improve health care? Do we need screening by the ophthalmologist based on this study? And on which ophthalmological diseases? It is difficult to treat only complaints without knowing what the underlying disorders might be. It is stated in the discussion that some complaints (most seen in PD) are possible PD pathology related. This is interesting however there is no explanation on this topic.

- In the discussion section, also a more in-depth discussion of the causes and consequences of the findings and a comparison with previous studies should be made. Now only the rationale that screening is important because of a high prevalence and a potential impact on daily life, is repeated several times in both the introduction and discussion.

- The SVCq is introduced as a questionnaire that screens for visual complaints in people with neurodegenerative diseases. However, the questionnaire was validated in people without neurological conditions. Please explain.

- How was the question on dry eyes established? Dry eyes syndrome is a diagnosis and not typically a visual complain. Dry eyes could lead to symptoms of paradoxically to watery/teary eyes, burning/sandy/itchy eyes and/or blurred vision.

- The conclusion drawn in the discussion that the SVCq is very different from other questionnaires such as the VFQ-25 and the VIPD-questionnaire is not clear to me. When compared especially the VIPD-Q and the SVCq many questions are similar, for example distorted images, hallucinations, painful eye, contrast, color vision, double vision. Also, the frequency never, often etc. is very similar. Could the authors explain what the added value of the SVCq is? I agree that structured questioning of visual complaints should become routine care.

- It seems like the severity of complaints score (on a scale of 1-10) was not used in the analyses. The indications ‘never/ hardly’etc. were used to classify severity. Please explain.

- A limitation of the present study is the lack of objective data on ophthalmological disorders. Even though medical files were studied, one of the problems is that ophthalmological disorders are not recognized (and diagnosed) in PD in clinical practice (also see a recent publication of Borm et al. J Neurol 2022). So, the number of OC’s may have been underestimated. In addition, there may still have been some selection bias because only PD patients visiting the outpatient clinic of a university hospital were included. This is a selected population.

- The authors state following: “Therefore, there is a risk of underestimation in both groups. The percentage of people who indicated having visited an ophthalmologist did not differ between the groups (see Table 1). It is therefore unlikely that results were influenced by missing a large number of ophthalmic conditions in one of the groups.”

This statement confused me, since underreporting of complaints is a reason to screen for visual complaints in PD, especially regarding the results of this study with high prevalence of visual complaints in persons with PD. Then it is paradoxal to assume that persons with PD did visit the ophthalmologist with their complaints earlier. Shouldn’t persons with PD show a much higher rate of visiting an ophthalmologist? Could the authors explain this?

- I would have liked to see analyses on the different age categories. A point of discussion is whether the high number of visual complaints and disorders in PD is a consequence of the disease or related to ‘general ageing’. It would be interesting to distinguish the age categories that were matched and perform the prevalence analyses for these different age categories.

- Were co-morbidities in the PD group considered in the analyses in a way?

- In the discussion it is stated that the high prevalence of visual complaints in people with PD may negatively impact daily life. Wasn’t this also studied here? In general, I find the analyses and conclusions on the clinical impact difficult to interpret; this could be described more clearly and explicitly.

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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: Yes: Mirella Barboni

Reviewer #2: No

Reviewer #3: No

Reviewer #4: No

Reviewer #5: No

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PONE-D-22-24932R1Prevalence and nature of self-reported visual complaints in people with Parkinson’s disease - Outcome of the Screening Visual Complaints questionnairePLOS ONE

Dear Dr. van der Lijn,

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.

Thank you for submitting your valuable work.

The reviews, which are insightful and interesting, pointed to some unexplained aspects and the authors were able to clarify them.

By my own reading, the manuscript still needs a bit of refinement, mostly related to generalisation, conciseness and the control of confounding factors. Although this may sound counterintuitive, I am keen to understand authors' claims and keen on reading a refined manuscript.

Briefly, as raised by one of the reviewers, you cannot just make too much speculation of your findings.

As we have observed through this time, PD's ocular manifestations are measured by the use of behavioural and physiological techniques. For example, we have noted that the dopamine depletion can affect eye's structure but also functional aspects from the retina to brain (based on ERPs, colour or chromatic discrimination etc.) This is not the focus of the manuscript, indeed, but those findings showed that other measures are reliable enough to detect ocular and visual manifestations, but also help, somehow, during the course of the disease. My concern here is: you are using a self-reported measure to characterise visual complains and, hence, because of that, you cannot just speculate that much with strong statements or even with some assertions. I think the authors can work on a little bit, refining the manuscript to ensure that readers and researchers can easily understand that your claims and assertions are tightened up to your results - without too much "physiology" or "all or nothing" claims.

You will notice that reviewers provided frank and clear comments and, in this round, they almost had no concerns. This is a good point, actually, and the authors can rest assure that this will be considered. However, more important is to provide a frank, clear and transparent perspective of your findings. I'd highly recommend the authors to rethink some statements where sound like "causal" relation of the self-related and visual complains - that should be interpreted as self-reported.

For example, one could say that he/she has no visual complain. But when comes to the physiological aspect, them could have cortical or subcortical damages. Well, by self-report them reported nothing, but physiologically, them have.

So basically I am gentle asking you to be cautious in this aspect and also refine your limitations pointing this difference of self-reported and other measures that really can show causal relation of the complains. Your study has merits and should be considered, but, considering these aspects, please opt to use a more conservative approach for debating your data and for your conclusions.

Overall, the manuscript reads better and has been really refined considering all of the reviewers’ comment. Also I commend the authors for their politeness and efforts. Wishing you success with the study and a very good refined version, so then we can proceed.

Please submit your revised manuscript by Jan 19 2023 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,

Thiago Fernandes, MA, EbS, Sp. Neuro, PhD

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.

Additional Editor Comments:

Please read my comments.

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 #3: All comments have been addressed

Reviewer #4: All comments have been addressed

Reviewer #5: (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 #3: Yes

Reviewer #4: Yes

Reviewer #5: Partly

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

Reviewer #1: I Don't Know

Reviewer #3: Yes

Reviewer #4: Yes

Reviewer #5: Yes

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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 #3: Yes

Reviewer #4: Yes

Reviewer #5: 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 #3: Yes

Reviewer #4: Yes

Reviewer #5: Yes

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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 discussion regarding the effects of abnormal eye movements on visual functions in PD has been added by the Authors. Thank you!

Reviewer #3: Dear Editor, all my issues were addressed and I considered that the manuscript is suitable to be published

Reviewer #4: (No Response)

Reviewer #5: I would like to thank the authors for addressing all comments of 5 reviewers. Most of my addressed points have been clarified.

Although, I still have concerns about the final conclusion that there are complaints without underlying OC.

In my opinion it is not possible to state this as part of the end conclusion without thorough ophthalmological assessment.

for example impaired color vison could be related to retinal dysfunction this is an OC (due to parkinson's or not) the same for dry eyes, blurred vision due to refractive errors and reading problems due to oculomotor problems or visual field deficitis.

Of course sometimes you don't know what the underlying cause to symptoms is and one can speculate it is parkinson's, but to state this with only self-reported OCs is difficult to accept for me. Especially noticing that PD patients underreport symptoms and therefore not go to eye care as often as they should.

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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: Yes: Mirella Barboni

Reviewer #3: Yes: Givago da Silva Souza

Reviewer #4: Yes: Sayantan Biswas

Reviewer #5: No

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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.

PONE-D-22-24932R2Prevalence and nature of self-reported visual complaints in people with Parkinson’s disease - Outcome of the Screening Visual Complaints questionnairePLOS ONE

Dear Dr. van der Lijn,

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. Thank you for addressing all comments. As mentioned before, these (10.1371/journal.pone.0272559 & https://doi.org/10.1371/journal.pone.0232232) are studies that could be considered as potential overlapping. I ask the authors to detail in the main text the main differences - with specific details re. the three studies. Also, I request the authors to disclose in a diffrent section of the file, next to the diclosures and/or conflict. 

Please submit your revised manuscript by Feb 26 2023 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,

Thiago P. Fernandes, PhD

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.

[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.

PONE-D-22-24932R3Prevalence and nature of self-reported visual complaints in people with Parkinson’s disease - Outcome of the Screening Visual Complaints questionnairePLOS ONE

Dear Dr. van der Lijn,

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.

I would like to thank you for the edits. To ensure adherence to PLOS policies concerning related studies / overlapping, I’d like to call out authors’ attention to a few another aspects. As observed in the main guidelines (https://journals.plos.org/plosone/s/ethical-publishing-practice#loc-submission-and-publication-of-related-studies), the authors will find:

“If related content is found to be too similar to the PLOS submission, or if a duplicate submission is discovered, we will reject the manuscript.

Duplicate content discovered after publication will be addressed depending on the degree of overlap. The journal may issue a correction or a retraction as appropriate.”

My concern is because you are pointing out that this study has findings on the same sample (PD’s) and the other was a validation (using the same sample). But you may think that others can say that your validation on the sample could be also interpreted as visual complaints. I understand the reasons underlying this, but also understand why to conduct another study, that’s why I think that a few things can be addressed before I continue with your study. I highly recommend the authors to address them (as also informed by the Staff), and my apologies for another round:

1. Please extend your sample – this will help bring the novel aspects idea. I assume the authors have a few more subjects on any database?
2. Please work on your Title and Methods to make clear: (i) studies won’t be considered as related or overlapped and (ii) your Methods should not be the same as your previous study, so you can link without repetition of the same words or write another

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Thiago Fernandes

PLOS ONE

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Prevalence and nature of self-reported visual complaints in people with Parkinson’s disease - Outcome of the Screening Visual Complaints questionnaire

PONE-D-22-24932R4

Dear Dr. van der Lijn,

Thank you for your prompt replies. First, I completely understand authors’ claim – and am not arguing this since these are good points. I called out authors’ attention due to PLOS policies (which I have been informed twice). While I think this is crystal clear, and am proceeding with your study, I just ask in a more friendly way to check again possibility of overlapping in future works using any kind of tool. My “advice” is just some systems will automatically say “no, this is overlapping, do not proceed” and will not let the authors’ explain. As I am sure you are aware of this, just think that my “advice” is because we all went through this kind of situation.

Apart from it, thank you for your explanations & importantly re. the strategy I thought was interesting (add more data). A few times you can bear with this request by others, but I have not seen any issue & think the reply was interesting.

Overall, if there is still any concern or thing remaining, PLOS will contact the authors directly. I am wishing you success with your application (am seeing you are PhD candidate) but also wishing success with your very good study.

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,

Thiago Fernandes, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Thank you for your prompt replies. First, I completely understand authors’ claim – and am not arguing this since these are good points. I called out authors’ attention due to PLOS policies (which I have been informed twice). While I think this is crystal clear, and am proceeding with your study, I just ask in a more friendly way to check again possibility of overlapping in future works using any kind of tool. My “advice” is just some systems will automatically say “no, this is overlapping, do not proceed” and will not let the authors’ explain. As I am sure you are aware of this, just think that my “advice” is because we all went through this kind of situation.

Apart from it, thank you for your explanations & importantly re. the strategy I thought was interesting (add more data). A few times you can bear with this request by others, but I have not seen any issue & think the reply was interesting.

Overall, if there is still any concern or thing remaining, PLOS will contact the authors directly. I am wishing you success with your application (am seeing you are PhD candidate) but also wishing success with your very good study.

Reviewers' comments: