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    Few Neuro-Ophthalmic Articles in Influential Journals

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    Although neuro-ophthalmology is an academic-oriented subspecialty, a recent study shows that it is underrepresented in influential ophthalmology and neurology journals, in both original research and litera­ture reviews as well as editorial board expertise.1

    Edward Margolin, MD, a study coauthor at the Uni­versity of Toronto in Toronto, Ontario, said the findings suggest that editorial priorities could be influencing the disproportionate publication of neuro-ophthalmology articles. Moreover, he stressed that neuro-ophthalmic research dissemination among general ophthalmolo­gists and neurologists is crucial because of the limited number of highly qualified medical providers in the extremely specialized and complex field of neuro-oph­thalmology. “At least 10% to 15% of patients seen in general ophthalmology practices will present with a problem that is relevant to neuro-ophthalmic knowl­edge,” said Dr. Margolin. “Practitioners must be edu­cated in these types of disease to best support prompt diagnosis and treatment.”

    A look at the literature. The researchers evaluated 10 ophthalmology and neurology journals, five in each specialty, over the last decade. Journals were selected for their high “impact factor,” the rate at which the average journal article is referenced in a specific time frame.

    A total of 104,558 articles were categorized as either “neuro-ophthalmology focused” or “other.” Each article was also classified as “teaching” or “nonteaching,” the latter of which included original research and literature reviews. Editors from each of the journals were identified and designated as “neuro-ophthalmologists” or “non–neuro-ophthalmologists” based on their medical training and clinical practice.

    The researchers then used descriptive statistics to determine the proportion of neuro-ophthalmology articles published in each journal every year across the 10-year span. In addition, they used correlation analysis to identify relationships between editorial board representation and publication frequency for teaching and nonteaching articles with a neuro-ophthalmology focus.

    Publication trends. Across all 10 journals, only 3.4% of the published content consisted of nonteaching neuro-ophthalmology articles, and only 1% to 7% of the editorial seats from each board were filled with neuro-ophthalmologists. Correlation analysis of the data also revealed that increased neuro-ophthalmology presence and expertise on editorial boards correlated with increased publication of neuro-ophthalmic teaching articles.

    A caveat. A limitation of the study, the authors wrote, is that they were unable to assess “a comparison dataset of articles”—submissions rejected during the editorial or peer review processes. Those data are not publicly available, they noted. This information might have helped to give a sense of the relative proportion of papers received that went on to be published and, perhaps, some insight into the selection process.

    Call for more published research. High-impact medical journals naturally seek out submissions that will appeal to their readers, resulting in more widely read and cited articles, Dr. Margolin said. However, he is concerned that the underrepresentation of published neuro-ophthalmic research within influential neurology and ophthalmology journals may hinder the widespread communication of knowledge that could benefit practitioners who treat patients with these less-common disorders.

    He suggested that editors may unknowingly be drawn toward submissions covering familiar subject matter sent from institutions with which they already have strong relationships. Conversely, they may shy away from articles that appear irrelevant to the bulk of their readership or are submitted by lesser-known researchers. Even so, said Dr. Margolin, it is important to address this apparent publication disparity and promote more neuro-ophthalmology research in high-impact journals.        

    —Julie Monroe


    1 Xie J et al. Can J Ophthalmol. Published online April 8, 2023.


    Relevant financial disclosures—Dr. Margolin: None.

    For full disclosures and the disclosure key, see below.

    Full Financial Disclosures

    Dr. Rochette None.

    Dr. Seibold Allergan: C; New World Medical: C; Oculus Surgical: C.

    Dr. Margolin None.

    Disclosure Category



    Consultant/Advisor C Consultant fee, paid advisory boards, or fees for attending a meeting.
    Employee E Hired to work for compensation or received a W2 from a company.
    Employee, executive role EE Hired to work in an executive role for compensation or received a W2 from a company.
    Owner of company EO Ownership or controlling interest in a company, other than stock.
    Independent contractor I Contracted work, including contracted research.
    Lecture fees/Speakers bureau L Lecture fees or honoraria, travel fees or reimbursements when speaking at the invitation of a commercial company.
    Patents/Royalty P Beneficiary of patents and/or royalties for intellectual property.
    Equity/Stock/Stock options holder, private corporation PS Equity ownership, stock and/or stock options in privately owned firms, excluding mutual funds.
    Grant support S Grant support or other financial support from all sources, including research support from government agencies (e.g., NIH), foundations, device manufacturers, and\or pharmaceutical companies. Research funding should be disclosed by the principal or named investigator even if your institution receives the grant and manages the funds.
    Stock options, public or private corporation SO Stock options in a public or private company.
    Equity/Stock holder, public corporation US Equity ownership or stock in publicly traded firms, excluding mutual funds (listed on the stock exchange).


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