Ocular Biomechanics and Glaucoma
, Bruno F. Fernandes 4,* and Renato Ambrósio, Jr. 1
Round 1
Reviewer 1 Report
This is an interesting and well written paper about the role of corneal biomechanics in the onset and development of glaucoma, that reports a modern technique of evaluating such biomechanics, for instance the corneal hysteresis and the correlated IOP.
I have no specific queries or comments pertaining to this manuscript.
Author Response
We thank the reviewer for the kind remarks. There were no comments to address.
Reviewer 2 Report
Quite interesting review paper on corneal biomechanics and glaucoma.
Several issues to be elucidated.
Definition of CH should be provided along with the units in which it is expressed and normal ranges.
Very interesting part of the review is on the trabecular meshwork stiffness. In fact trabecular meshwork itself is not a cornea isn't it? In fact it goes towards molecular biology rather than biomechanics. Perhaps the title of the paper should be changed.
Conclusions are too general and not useful. In general one does not feel the main message of this review that makes the relevance much diminished.
Abstract says it can help optimize clinical and surgical treatments. How?
Author Response
Point 1: The definition of CH should be provided along with the units in which it is expressed and normal ranges.
Response 1: a detailed definition of CH was provided in lines 57-61. We added the units and the normal range in the revised version of the manuscript, along with the reference below. (lines 61-62)
Shah S, Laiquzzaman M, Bhojwani R, Mantry S, Cunliffe I. Assessment of the biomechanical properties of the cornea with the ocular response analyzer in normal and keratoconic eyes. Invest Ophthalmol Vis Sci. 2007 Jul;48(7):3026-31. doi: 10.1167/iovs.04-0694. PMID: 17591868.
Point 2: Very interesting part of the review is on the trabecular meshwork stiffness. In fact, trabecular meshwork itself is not a cornea, isn't it? In fact, it goes towards molecular biology rather than biomechanics. Perhaps the title of the paper should be changed.
Response 2: We thank you for your comment and fully agree. We changed the title of the manuscript to “ocular biomechanics and glaucoma”, as we cover not only corneal biomechanics but also other ocular structures.
Point 3: Conclusions are too general and not useful. In general one does not feel the main message of this review that makes the relevance much diminished.
Response 3: The Conclusion was expanded to highlight the main message of the manuscript (lines 352-364).
Point 4: Abstract says it can help optimize clinical and surgical treatments. How?
Response 4: The Abstract was expanded to detail how it can aid optimize clinical and surgical treatments (lines 19-22).
Reviewer 3 Report
The authors must be congratulated for this comprehensive review, nevertheless, I suggest the following:
- Include in table 1 (and in the text describing the Corvis DCR parameters) HC dArc Lenght and HC deflection length
- Please substitute the references of reviews (at least some, there are too many) for the original references. Particularly refs 17, 21, 24, 40 and 79.
- I think it is not appropriate to describe the possible relevance of the Covis DCR parameters in the section 4, entitled "Hysteresis and Glaucoma", a new section (perhaps 5. DCR parameters and glaucoma) should be added, and there the clinical relevance of the DCR parameters and Corvis indexes (effect of PGs on them, the possible behavior as a risk factor of corneal stiffness parameters, ref 7, etc) can be discussed in a separate section.
Author Response
Point 1: - Include in table 1 (and in the text describing the Corvis DCR parameters) HC dArc Lenght and HC deflection length
Response 1: HC dArc Lenght and HC deflection length were included in the text (line 126 ) and Table 1.
Point 2: Please substitute the references of reviews (at least some, there are too many) for the original references. Particularly refs 17, 21, 24, 40, and 79.
Response 2: The above-mentioned references were replaced with the original source whenever possible.
Point 3: I think it is not appropriate to describe the possible relevance of the Covis DCR parameters in the section 4, entitled "Hysteresis and Glaucoma", a new section (perhaps 5. DCR parameters and glaucoma) should be added, and there the clinical relevance of the DCR parameters and Corvis indexes (effect of PGs on them, the possible behavior as a risk factor of corneal stiffness parameters, ref 7, etc) can be discussed in a separate section.
Response 3: The discussion regarding Covis DCR parameters was slit into a new section: DCR parameters and glaucoma (line 323)..
