A Review on Pathogens and Necessary Diagnostic Work for Bleb-Related Infections (BRIs)
, Leonidas Doumazos 1, Dimitra Mitsopoulou 1, Mario A. Economou 2,3, Ioanna Mylona 4, Chrysostomos Dimitriou 5, Petros Petrou 1 and Ilias Georgalas 1Round 1
Reviewer 1 Report
11: conjunctival swaps
“swaps” typo error “swabs”
Please highlight the importance of the timing of the sampling procedure in relation to the antibiotic treatment (given that antibiotic treatment increases the chances of a negative culture).
Please mention the recommended site for sampling of the conjunctiva (i.e. over the affected bleb, from the inferior fornix, from neighbouring conjunctiva, etc) to compare the nature of the organism isolated and differentiate flora from the active invading pathogen.
12. Aqueous and Vitreous Samples
Please mention the degree of correlation in the published studies between the isolated pathogens from conjunctival swabs and pathogens isolated from the AC or vitreous. This may highlight the importance of conjunctival swabs in the diagnosis and management of BRI.
Please comment on the possibility of mixed infection (polymicrobial infection) in BRI and the possible pathogens involved.
Author Response
Response to reviewer comments
We wish to thank the anonymous reviewers for their time and careful review of our manuscript. Changes in the manuscript have been highlighted in yellow. A detailed response to each and every comment follows:
Reviewer #1
- >11: conjunctival swaps
“swaps” typo error “swabs”
Response: Thank you for your comment, this has been corrected
- Please highlight the importance of the timing of the sampling procedure in relation to the antibiotic treatment (given that antibiotic treatment increases the chances of a negative culture).
Response: Thank you for your comment, your suggestion has been included in the revised manuscript (lines 186-190)
- Please mention the recommended site for sampling of the conjunctiva (i.e. over the affected bleb, from the inferior fornix, from neighbouring conjunctiva, etc) to compare the nature of the organism isolated and differentiate flora from the active invading pathogen.
Response: Thank you for your constructive suggestion, this recommendation has been included in the revised manuscript (lines 177-185)
- Aqueous and Vitreous Samples
Please mention the degree of correlation in the published studies between the isolated pathogens from conjunctival swabs and pathogens isolated from the AC or vitreous. This may highlight the importance of conjunctival swabs in the diagnosis and management of BRI.
Response: Thank you for your comment this information has been inserted in the revised manuscript (lines 201-205)
- Please comment on the possibility of mixed infection (polymicrobial infection) in BRI and the possible pathogens involved.
Response: Thank you for your suggestion, this has been added in the revised manuscript (lines 185-188)
Author Response File: 
Author Response.docx
Reviewer 2 Report
Authors wrote an interesting article.
Few improvements are needed.
BRIs are clinically categorized into localized inflammation (or infections?) with various degree of anterior chamber involvement namely blebitis and bleb associated endophthalmitis (BAE) in which there is vitreous involvemen
Please improve the English level
Please improve the limitations of the study
Please add sentence or section about future way do improve diagnostics in infection. I'd suggest to add a sentence regarding metageniomics. Here few papers. PMID: 31276030 and PMID: 31179394
Author Response
Response to reviewer comments
We wish to thank the anonymous reviewers for their time and careful review of our manuscript. Changes in the manuscript have been highlighted in yellow. A detailed response to each and every comment follows:
Reviewer #2
Few improvements are needed.
- >Please improve the English level
Response: Thank you for your suggestion, changes have been made throughout the manuscript with the aid of a native speaker, too numerous to mention
- >Please improve the limitations of the study
Response: Thank you for your helpful comment, a limitations section has been included in the revised article. (lines 360-363)
- >Please add sentence or section about future way do improve diagnostics in infection. I'd suggest to add a sentence regarding metageniomics. Here few papers. PMID: 31276030 and PMID: 31179394
Response: Thank you for your helpful comment, metageniomics have been referenced with your two suggested papers
Author Response File: Author Response.docx
Round 2
Reviewer 2 Report
Approved
