Prevalence and associations of anisometropia with spherical ametropia, cylindrical power, age, and sex, based on 134,603 refractive surgery candidates

Mona Deuchert; Andreas Frings; Vasyl Druchkiv; Jakob Schweighofer; Sajjad Muhammad; Stephan Linke; Toam Katz

doi:10.1371/journal.pone.0315080

Peer Review History

Original SubmissionMay 20, 2024
28 Jun 2024 Decision Letter - Der-Chong Tsai, Editor PONE-D-24-18058Prevalence and Associations of Anisometropia with Spherical Ametropia, Cylindrical Power, Age, and Sex, Based on 134,603 Refractive Surgery Candidates PLOS ONE Dear Dr. Frings, Thank you for submitting your manuscript to PLOS ONE. The manuscript has been assessed by our two expert reviewers, and their detailed comments are appended below. Reviewers raised a number of concerns regarding the unclear study methods, limited discussion, and lack of updated reference. Please carefully revise the manuscript to address all concerns raised by the reviewers. Please submit your revised manuscript by Aug 12 2024 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. 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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: 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 authors retrospectively investigated the rates and associated factors of anisometropia using data from 134,603 refractive surgery candidates. The study is extensively analyzed, and I would like to address several points: 1. This study involved a study population who visited refractive clinics for refractive surgery. They were either myopic (80.8%) or hyperopic, which is different from the general population. Moreover, gender, income, and many other factors may also affect the willingness to undergo refractive surgeries. The authors should be cautious when interpreting the results and should inform the readers about the impact of selection bias. For example, the prevalence and severity of anisometropia may be overestimated within the SE range of -1.0D to +1.0D. Few isometropic subjects with SE between -1.0D and +1.0D would seek refractive surgery. 2. For the definition of anisometropia, does it include a difference of 1 Diopter (≥1D) or not (>1D)? In Line 147 and Line 163, it seems that 1D is not included as anisometropia. However, in Line 87 and Line 149, 1D is classified as mild anisometropia. In Table 1, does the symbol “[1,max]” indicate that an SE difference from 1 to the maximum value is considered anisometropia? 3. In Table 1, Figure 1, Figure 2, and Figure 3, please do not use parentheses “()” or brackets “[]” to indicate ranges. Instead, use symbols such as “>”, “≥”or “<” to clearly denote the ranges. 4. What are the exclusion criteria of the study? Were subjects with previous refractive surgery or cataract surgery in any eye excluded from the analysis? 5. The results for hyperopic subgroups regarding the association of anisometropia with spherical ametropia and cylindrical power differ from the results of Qin et al. (2005) and Linke et al. (2011). Please compare these results. Reviewer #2: The following points should be considered; 1- Please clarify certificate approval number 2- Introduction is not sufficient regarding the domain of study and what will added 3- Please clarify inclusion and exclusion criteria in details 4- Please clarify setting ( study location) and study design 5- Please clarify methods of examinations of visual acuity, IOP, refraction , pupil 6- Discussion is not sufficient regarding comparison with recent citations 7- Conclusion should be condensed 8- Please added recent references 9- Please clarify consent for publications, funding, avialbility of materials and data, abbreviations, conflict of interests, standards of reporting, ORCID of authors 10 Some typographical errors should be corrected ****** 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: Yu-Chieh Yang 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/. 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Revision 1
28 Aug 2024 Author Response Dear Mr Der-Chong Tsai, Thank you for inviting us to submit a revised draft of our manuscript entitled, "Prevalence and associations of anisometropia with spherical ametropia, cylindrical power, age, and sex, based on 134,603 refractive surgery candidates" (PONE-D-24-18058) to PLOS ONE. We also appreciate the time and effort you and each of the reviewers have dedicated to providing insightful feedback on ways to strengthen our paper. Thus, it is with great pleasure that we resubmit our article for further consideration. We have incorporated changes that reflect the detailed suggestions you have graciously provided. We also hope that our edits and the responses we provide below satisfactorily address all the issues and concerns you and the reviewers have noted. To facilitate your review of our revisions, the following is a point-by-point response to the questions and comments delivered in your letter dated June 28, 2024: EDITORIAL COMMENTS 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. Response: We have ensured that our manuscript meets PLOS ONE's style requirements, including those for file naming. 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. Response: We have obtained written consent from our patients, which were fully anonymized. This is now stated in detail in lines 85 to 91. 3. We note that your Data Availability Statement is currently as follows: [All relevant data are within the manuscript and its Supporting Information files.] Please confirm at this time whether or not your submission contains all raw data required to replicate the results of your study. Authors must share the “minimal data set” for their submission. (…) Response: We now included the minimal data set necessary to replicate our study findings as a xlsx-File in the Supporting Information section. 4. Please include your full ethics statement in the ‘Methods’ section of your manuscript file. In your statement, please include the full name of the IRB or ethics committee who approved or waived your study, as well as whether or not you obtained informed written or verbal consent. If consent was waived for your study, please include this information in your statement as well. Response: We have included the full ethics statement in the ‘Methods’ section of your manuscript file. We have obtained written consent. Cf. lines 85-91 REVIEWER 1: 1. This study involved a study population who visited refractive clinics for refractive surgery. They were either myopic (80.8%) or hyperopic, which is different from the general population. Moreover, gender, income, and many other factors may also affect the willingness to undergo refractive surgeries. The authors should be cautious when interpreting the results and should inform the readers about the impact of selection bias. For example, the prevalence and severity of anisometropia may be overestimated within the SE range of -1.0D to +1.0D. Few isometropic subjects with SE between -1.0D and +1.0D would seek refractive surgery. Response: Thank you for your valuable comment on the selection bias. We kindly refer to lines 350 to 388 with an in-depth discussion on selection bias. 2. For the definition of anisometropia, does it include a difference of 1 Diopter (≥1D) or not (>1D)? In Line 147 and Line 163, it seems that 1D is not included as anisometropia. However, in Line 87 and Line 149, 1D is classified as mild anisometropia. In Table 1, does the symbol “[1,max]” indicate that an SE difference from 1 to the maximum value is considered anisometropia? Response: A difference of 1 Diopter (≥1D) is consistently included as anisometropia. We have corrected the typographical errors in line 87 (now line 111) and in line 149 (now line 173). Table 1 (lines 181-182) was insofar clarified (see also Point 3 below). 3. In Table 1, Figure 1, Figure 2, and Figure 3, please do not use parentheses “()” or brackets “[]” to indicate ranges. Instead, use symbols such as “>”, “≥”or “<” to clearly denote the ranges. Response: We changed Table 1 and the Figures accordingly. In the course of adjusting the figure legends, we switched to Mild/Moderate/Severe anisometropia in line with the definition we give in the manuscript text. 4. What are the exclusion criteria of the study? Were subjects with previous refractive surgery or cataract surgery in any eye excluded from the analysis? Response: We specified the exclusion criteria (patients with a previous surgical intervention, such as cataract surgery, or patients with an eye condition) in lines 83-84. 5. The results for hyperopic subgroups regarding the association of anisometropia with spherical ametropia and cylindrical power differ from the results of Qin et al. (2005) and Linke et al. (2011). Please compare these results. Response: You have of course made an interesting and important point here. We gladly added this to the discussion and compared both aforementioned studies with our results (cf. lines 390 onwards, lines 414 onwards and lines 456 onwards in the Discussion chapter). REVIEWER 2: 1. Please clarify certificate approval number Response: We added the number (#2021-1278) in lines 88-89. 2. Introduction is not sufficient regarding the domain of study and what will added Response: We amended our introduction and expanded on the domain of study in lines 70 to 75 in the Introduction. 3. Please clarify inclusion and exclusion criteria in details Response: We specified the inclusion criteria in lines 78-83 and furthermore exclusion criteria (patients with a previous surgical intervention, such as cataract surgery, or patients with an eye condition) in lines 83-84. 4. Please clarify setting (study location) and study design Response: We amended our Methods section (lines 77 onward) to include more details on study setting and design. 5. Please clarify methods of examinations of visual acuity, IOP, refraction , pupil Response: We amended our Methods section in lines 92-100 to include more details. 6. Discussion is not sufficient regarding comparison with recent citations Response: We included three more recent citations (2020, 2023, 2024) in lines 408-412 of our Discussion. 7. Conclusion should be condensed Response: We revised and condensed the Conclusion (cf. Lines 495-502) 8. Please added recent references Response: We added 5 recent references in total (cf. lines 51-54). 9. Please clarify consent for publications, funding, avialbility of materials and data, abbreviations, conflict of interests, standards of reporting, ORCID of authors Response: We clarified consent for publication (cf. lines 90-91) and included additional information on funding and competing interests in a separate ‘Additional Information’ section (cf. lines 558-565). We included the minimal data set required to replicate our study in an Excel file in the Supporting Information section. Abbreviations were consistently introduced at first mention. My ORCID number: 0000-0001-8977-4261 10. Some typographical errors should be corrected Response: We revised the manuscript and corrected remaining typographical errors. Once again, we extend our gratitude for the valuable insights and your dedication in reviewing our manuscript. We hope that the revised version of our manuscript will meet your approval. Should you have any further questions or require additional information, please feel free to contact us. Thank you for your time and consideration. Sincerely, Andreas Frings, MD Corresponding Author University Hospital Düsseldorf Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0315080.r002
22 Sep 2024 Decision Letter - Der-Chong Tsai, Editor PONE-D-24-18058R1Prevalence and Associations of Anisometropia with Spherical Ametropia, Cylindrical Power, Age, and Sex, Based on 134,603 Refractive Surgery CandidatesPLOS ONE Dear Dr. Frings, 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 06 2024 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, Der-Chong Tsai, MD, 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.] 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: (No Response) ******** 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 ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: 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 ****** 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: No ****** 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: Thank you for your response. The authors have addressed most of the points. However, in the "Discussion" section, I hope the authors can provide explanations for the data rather than simply comparing the results with previous studies. In particular, I suggest elaborating on the sections regarding "selection bias" and the "associations between anisometropia and spherical ametropia." What are the potential reasons for the observed differences in data compared to previous research? Are there any possible physiological explanations, or could selection bias have influenced the results? Additionally, I recommend having the manuscript reviewed by a native English speaker to enhance the language quality. ****** 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: Yu-Chieh Yang ******** [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.0315080.r003
Revision 2
1 Nov 2024 Author Response Dear Mr Der-Chong Tsai, Thank you for revising our manuscript: "Prevalence and associations of anisometropia with spherical ametropia, cylindrical power, age, and sex, based on 134,603 refractive surgery candidates" (PONE-D-24-18058 / PONE-D-24-18058R1) to PLOS ONE, a second time. We are grateful for the time and effort you and the reviewers have dedicated once again on our paper. We have made revisions based on the detailed suggestions you kindly provided and hope that our edits, along with the responses below, satisfactorily address all the concerns and issues raised. To facilitate your review of our revisions, the following is a point-by-point response to the questions and comments delivered in your letter dated September 22, 2024: 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. --> Response: We corrected some publication data in line 550 and 582 next to several typographical corrections. In lines 583-584 we have added an additional reference (Discussion chapter, see reviewer comments below) so that we now consider the reference list complete and correct. We furthermore checked that no cited article has been retracted. REVIEWER COMMENTS 1. I recommend having the manuscript reviewed by a native English speaker to enhance the language quality. --> Response: We had the manuscript proofread and corrected by a native English speaker. 2. Thank you for your response. The authors have addressed most of the points. However, in the "Discussion" section, I hope the authors can provide explanations for the data rather than simply comparing the results with previous studies. In particular, I suggest elaborating on the sections regarding "selection bias" and the "associations between anisometropia and spherical ametropia." What are the potential reasons for the observed differences in data compared to previous research? Are there any possible physiological explanations, or could selection bias have influenced the results? --> Response: We have comprehensively revised the chapters on “selection bias” and “associations between anisometropia and spherical ametropia”. In doing so, we have added further explanations for our results and have addressed selection bias, which could result from the structure of the study population, much more extensively than before. We have also incorporated our clinical experience into the discussion. In terms of potential physiological explanations for our results, we have added further literature and ultimately come to the conclusion that, due to the multifactorial causes of anisometropia, further research in this area on the basis of the general population is indicated in order to be able to completely rule out selection bias. However, in the discussion we also address why we nevertheless consider our results to be of high relevance. Thank you for your time and consideration. Sincerely, Andreas Frings, MD Corresponding Author University Hospital Düsseldorf Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0315080.r004
21 Nov 2024 Decision Letter - Der-Chong Tsai, Editor Prevalence and associations of anisometropia with spherical ametropia, cylindrical power, age, and sex, based on 134,603 refractive surgery candidates PONE-D-24-18058R2 Dear Dr. Frings, 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 will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, 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, Der-Chong Tsai, MD, PhD 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 ******** 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: (No Response) ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: (No Response) ****** 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: (No Response) ****** 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: (No Response) ****** 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: (No Response) ****** 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: Yu-Chieh Yang ******** https://doi.org/10.1371/journal.pone.0315080.r005

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