PONE-D-22-08228Effects of acupuncture on age-related macular degeneration: a systematic review and meta-analysis of randomized controlled trialsPLOS ONE

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Reviewer #1: Yes

Reviewer #2: Partly

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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: No

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: This meta-analysis aims to review the clinical efficacy of acupuncture in the treatment of age-related macular degeneration (AMD). In fact，there is no high-quality evidence that acupuncture is effective in treating patients with AMD. Analysis showed patients with dry AMD may benefit from acupuncture. Overall, this study has clinical significance. It can provide some evidence for clinical practice and further clinical trial.

Figures should be more clear.

Reviewer #2: Overall, the methodology is acceptable overall. However, there are some limitations as follows.

1. In methods, the criteria for considering studies for the review should move in front of the search strategy. And in 2.3.1, just RCTs is enough, the second half of the sentences could be omit.

2. In 2.3.2, at least one diagnostic criteria should be the references.

3. 2.4, I believe the exclusion criteria is not enough.

4. In the search strategy, supplement 1.1, the search strategies are not rigorous, Published, highly sensitive, validated search filters to identify randomized trials should be considered, not just RCT(publication Type).

5. in 2.5, the duplicate documents should be filtered by software, not human.

6. Some of the methodologies are outdated: risk of bias tools 2.0 should be used; Revman Web should be used, or at least Revman 5.4.

7. In 3.3, as there is no sham acupuncture, how to blind the practioners?

8. In table 3, is the P value for the heterogeneity, or for the effect size RR.

9. In 3.4.4, one study reported 10 of 22 patients in the acupuncture group had bleeding. I assume there are more discussion about the safety of acupunture of AMD, the acupoints, the manipulation, etc..

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Reviewer #1: No

Reviewer #2: Yes: Chen, Chao

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Effects of acupuncture on age-related macular degeneration: a systematic review and meta-analysis of randomized controlled trials

PONE-D-22-08228R1

Dear Dr. Zhou,

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,

Shiying Li, MBBS

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

All comments are responsed, I suggested to accept it.

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 #3: All comments have been addressed

Reviewer #4: (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 #3: Partly

Reviewer #4: Yes

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

Reviewer #3: Yes

Reviewer #4: 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 #3: Yes

Reviewer #4: Yes

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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 #3: Yes

Reviewer #4: 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 #3: 1. Line 18~19, please describe the ‘relationship’ more exactly, it would be better to describe what relationship is.

2. Line 36, please add the full name of the ‘RCT’ because this is the first time to be here.

3. Table 1, there are some overlapped number markers (‘Outcomes’), it would be better to make them more clear by adjusting them, for example use 1~4 to replace ‘1234’

4. Line 250~259, when you discussed the ‘TCM theory’, it would be better to add more references to address this question, especially more discussion about why the acupuncture is not effective in treating the patients with AMD.

5. In Discussion, it would be better to discuss the effects of the ‘acupuncture points’, for example BL1.

Reviewer #4: 1.The literature collection process is detailed and clear, but most of the content of the discussion is mainly summary, the review content can be further enriched.

2.Possible bias could be more specific

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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 #3: No

Reviewer #4: No

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