From the Editors

The American Society of Retina Specialists (ASRS) is the world’s largest inclusive retina organization. It was founded in 1982 to disseminate best care practices, evaluate novel treatment strategies, investigate new technologies, and continuously drive improved care for retina patients. Traditionally, we have used the ASRS Annual Scientific Meeting to accomplish these goals, but like all major meetings, presentations are often short and absent of rigorous discussion. Our first foray into member publications was Retina Times.

Retina Times began as a newsletter in 1999 and has since expanded to nearly 80 pages, including reports from ASRS committees, point/counterpoint discussions, key opinion leader reviews of seminal topics (uveitis, ocular oncology, pediatrics, surgical techniques), case presentations (X-Files), updates on ocular imaging and clinical trials, as well as editorials from the ASRS president, the president of the Foundation of the ASRS, and our editor in chief. Retina Times has become a critical component of the ASRS, bringing activities of our society and its members to the fore.

As Retina Times progressed, it became obvious to the ASRS Executive Committee and Board that the publication lacked the ability to incorporate peer-reviewed articles and disseminate them to our members—and throughout the national and international retina community. Retina specialty-focused journals were rare just a few years ago; many authors were experiencing long waits to publication, and full published articles were typically not available for free access. After extensive discussion, we at the ASRS felt it was imperative to begin our first retina specialty journal—and the Journal of VitreoRetinal Diseases (JVRD) was born.

The launch of any journal is challenging, and like all things ASRS, this was done thoughtfully, using our executive committee, board, and membership. After a national search, we identified Donald J. D’Amico, MD, as our first editor in chief. Dr D’Amico is well known to the ASRS and to the retina academic and research field. He is the chair of the Ophthalmology Department at Weill Cornell Medical Center, has served in multiple leadership roles throughout the field including executive participation in our sister societies, has a strong presence internationally as a director/moderator in multiple international meeting venues, and is routinely involved in teaching internationally.

With Dr D’Amico’s acceptance of the founding editor-in-chief role, we began to flesh out the Journal—identifying our publisher (SAGE Publications), deciding to provide both a print edition and electronic access to subscribers, determining our bimonthly publishing schedule, establishing our manuscript focus (retina-specific original manuscripts, case series, case reports, editorials, and special publications such as retina clinical practice papers)—and, critically, appointing the Journal leadership team.

The JVRD leadership team includes:

• 6 associate editors: Dean Eliott, MD (Harvard); Marta S. Figueroa, MD, PhD (Vissum); Thomas R. Friberg, MD (University of Pittsburgh); Tarek S. Hassan, MD (William Beaumont School of Medicine); Henrich Heimann, MD (Royal Liverpool University Hospital); and John T. Thompson, MD (University of Maryland)

• 26 editorial board members, with 3 deputy editors (Szilárd Kiss, MD [Weill Cornell Medical College], Mario R. Romano, MD, PhD [Humanitas University], and Yoshihiro Yonekawa, MD [Massachusetts Eye and Ear, and Boston Children’s Hospital])

As JVRD launched in 2017, it immediately became clear that the need for retina specialty publications using the ASRS’s resources was important not only to our field in North America, but also internationally. JVRD reached 2921 subscribers in its first year, and as of 2021, reaches 13 754 subscribers around the world.

The Journal grew rapidly, seeing an increase in submissions along with an improvement in the quality of the manuscripts undergoing review. Hoping to rapidly obtain PubMed recognition, JVRD submitted its application to PubMed Central (PMC) in August 2017. In hindsight, that application was too early with our Journal still establishing itself within the retina specialty. Our application was declined; the primary reason given was that the reviewed manuscripts would benefit from improvement.

PMC’s comments focused on small sample sizes and the lack of control groups. They also noted their concern about reproducibility of the described methods that made the reported studies potentially difficult to replicate. PMC remarked on the significant variability in the number of references for the accepted manuscripts and implied that more uniformity within the JVRD submission guidelines would be beneficial.

Interestingly, PMC noted that they found JVRD’s case reports, case series, and reviews to be of better quality. Because our subspecialty-focused journal covers a unique field, many of our papers report small patient numbers of “orphan” diseases, as we often are at the forefront of the field. These studies come with a challenge in scientific review as traditional “controls” are typically standard of care; frequently, randomization/stratification is limited by the small number of cases, and larger patient series are typically accrued over several years.

In these manuscripts, as in much of subspecialty medicine, focus is driven by statistically valid positive analysis. Negative outcomes are typically limited by the lack of power and are reviewed by the Journal with that caveat, even with larger series. As such, it remains difficult to generate meaningful power analysis for most retina-specific conditions. For JVRD and other subspecialty journals, disseminating information is critical to care in the field but requires an understanding of the retina, its clinical/research focus, and both the strengths and limitations of subspecialty study design and reporting.

Nonetheless, JVRD, the ASRS, and our publisher, SAGE, took these comments to heart and immediately instituted policy changes to address the suggestions and to, thereby, improve the quality of our manuscripts. The ASRS also directly hired an independent medical editor to oversee developmental editing and prepublication copy review of every accepted article.

Over the last 5 years, the Journal has continued to grow substantially:

• When JVRD was announced and began soliciting manuscripts in 2016, the Journal received 65 submissions. In 2020, JVRD received 347 submissions, with our acceptance rate at approximately 45%.

• Since launch, JVRD has averaged 42 days to the first decision and 54 days to final decision, including peer review.

• In 2017, JVRD received 8698 total full-text downloads, as compared with 2020, when the Journal received 14 307 downloads.

Now, after a publication track record approaching 5 years, we are constructing our submission for PMC/PubMed recognition.

This recognition, we believe, will both encourage manuscript submissions from our retina-specialty community and enhance national and international access to these manuscripts. To support this submission, in 2020, the ASRS assembled a task force comprising senior academic and private-practice retina experts to review the quality of articles published in JVRD.

This independent task force included Dean Eliott, MD (Harvard Medical School); Mangot Gill, MD (Northwestern University Feinberg School of Medicine); Jeffrey S. Heier, MD (Ophthalmic Consultants of Boston); Lisa C. Olmos de Koo, MD, MBA (University of Washington Eye Institute); Theodore Leng, MD, MS (Byers Eye Institute at Stanford University School of Medicine); and Timothy G. Murray, MD, MBA (Murray Ocular Oncology and Retina). Every member of this task force either serves in an editorial board role and/or reviews for multiple retina journals. The task force focused on original research, case series, and case reports—and the results were very encouraging.

The task force, using a standardized methodology, scored all reviewed manuscripts with a grade of excellent or good and suggested minimal changes in our submission and review process. One incorporated change included a standardized addition to our review process that acquired defined information on the reviewed manuscript along with our traditional free-form comments to the author and editor.

Overall, the task force found all manuscripts appropriately referenced. Study design and methodology were subspecialty consistent with best clinical practices, and virtually all papers were viewed as adding to our scientific knowledge of the field; many were considered novel research.

Task force reviewers highlighted 1 manuscript that reported a multicenter, retrospective review on a rare condition (pediatric macular holes), which was the single largest publication series on that topic to date. Another reviewer identified a manuscript and described it as a “valuable addition to literature describing novel gene sequences.” The task force strongly agreed that JVRD is one of the top 5 retina subspecialty journals, even though other journals have attained PMC/PubMed inclusion.

One concern of our initial PMC/PubMed review focused on small sample sizes with associated statistical limitations. Many of our published articles, even with the small sample size, represented either the first publication on the study subject or were the largest series reported to date. These distinctions are critical in reviewing JVRD.

For our ASRS members, we have included a recognition process for awarding points for manuscript submission and participating as JVRD peer reviewers. Having actively participated with several specialty-specific and general medicine/science publications, we must compliment the focus of the ASRS team and our Society for its ongoing contributions to the JVRD.

JVRD has reached a milestone in publication metrics, quality, number of submissions, strict rejection and acceptance criteria, and multitiered peer review and has received major support from the ASRS. In this regard, JVRD will seek PMC/PubMed inclusion with its planned upcoming submission. Hopefully, our next update will document our inclusion in PubMed.

Donald J. D’Amico, MD 
JVRD Editor in Chief
Professor and Chair
Department of Ophthalmology
Weill Cornell Medical College
Timothy G. Murray, MD, MBA 
JVRD Associate Editor
President, Foundation of the ASRS
Jill F. Blim, MS
Executive Vice President, ASRS