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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Case report
Full Version
Bilateral Congenital Macular Coloboma: A Case Report
Correspondence Address :
Manisha Nada,
22/9 J, Medical Campus, PGIMS, Rohtak, Haryana, India.
E-mail: manisha_nada@rediffmail.com
Macular coloboma is a rare disorder with congenital retinochoroidal defect. It has been divided into three categories- Pigmented macular coloboma, non pigmented macular coloboma and macular coloboma with abnormal vessels. Here, the authors present two cases of bilateral congenital macular coloboma. The first case was a 25-year-old male with diminution of vision in both eyes since childhood with no associated family history and no history of any systemic illness. His serological investigations were unremarkable. Case-2 was a nine-year-old male who was accompanied by his mother with vague history of rubbing of both eyes since two months with no significant medical and family history. Patient was found to have diminished vision bilaterally during ophthalmological examination. No evidence of infectious disease could be found on laboratory investigations. Paediatric consultation of the patient was unremarkable. Diagnosis was made after correlating the clinical and Ocular Computed Tomography (OCT) findings. Case-1 is on regular follow-up since three years while Case-2 was lost to follow-up. It is very important to reach at a diagnosis in such cases as there are many conditions which can mimic macular coloboma and treatment modalities vary accordingly. Although visual prognosis in cases of macular coloboma is poor, regular follow-up of the patient is of utmost importance in order to monitor visual acuity and posterior segment for any retinal breaks at the edge of coloboma.
Barrage laser, Macular scars, Non pigmented macular coloboma, Pigmented macular coloboma
Case-1
A 25-year-old male presented to ophthalmology department with the chief complaint of diminution of vision in both eyes since childhood. There was no significant history of perinatal infections, trauma or any developmental delay. Family history was not significant. Patient had consultations in the past regarding his complaints but no records were available with the patient. General and systemic examination of the patient was unremarkable. Ocular examination showed best corrected visual acuity of 4/60 in Right Eye (RE) and 5/60 in Left Eye (LE). His eye position was orthophoric and ocular movements were within normal limits. His pupils were isocoric and pupillary reaction to light was prompt in both eyes. Anterior segment was within normal limits bilaterally. Axial length in RE and LE measured 22.48 mm and 22.57 mm, respectively. Posterior segment examination showed a round punched out lesion of around 2DD with line of pigmentation and choroidal vessels at the base in both eyes without scleral ectasia (Table/Fig 1). Intraocular pressure was 16 mmHg in both eyes. Colour vision of patient was within normal limits. Provisional diagnosis of bilateral macular coloboma was made. Results of laboratory tests which included serum IgG and IgM titres for Toxoplasma, Rubella, Cytomegalovirus and Herpes simplex measured by enzyme linked immunosorbent assay were negative. Treponema pallidum hemagglutinin test was within normal limits. OCT findings revealed bilateral punched out morphology at the macula with atrophy of neurosensory retina, thus confirming the diagnosis of bilateral pigmented macular coloboma (Table/Fig 2). Patient was counseled about the poor visual prognosis. No active intervention was done but patient was kept on six monthly follow-up in order to monitor the status of visual acuity and posterior segment. No deterioration of visual acuity or posterior segment status including retinal breaks was noted at 3rd year of follow-up visits.
Case-2
A nine-year-old male child presented to outpatient department of ophthalmology with chief complaint of constant rubbing of both eyes since two months. It was associated with history of difficulty in viewing the blackboard in class. No history of deviated eye or abnormal eye movements was reported. The child was born out of non-consanguineous marriage and there was no history of any ocular disease in the family. Perinatal and postnatal period of the child was uneventful with normal developmental milestones. No significant medical and surgical history was reported. General and systemic examination of the patient was within normal limits. The patient underwent complete ocular examination which showed that his best corrected visual acuity in RE was 6/24 with refractive correction of -3DS -1.5DC at 180° and in LE was 6/60 with refractive correction of -5DS -1DC at 100°. His eye position was orthophoric with normal ocular motility and no evidence of nystagmus. Axial length in RE and LE was 21.35 mm and 21.50 mm, respectively. Anterior segment examination was within normal limits with round, regular and reactive pupils. Fundoscopic evaluation revealed a round macular lesion measuring about 1.5DD bilaterally with non-ectatic sclera and pigment clumps at the base (Table/Fig 3). Intraocular pressure was 14 mmHg in RE and 16 mmHg in LE. Colour vision was found to be within normal limits bilaterally. Provisional diagnosis of bilateral congenital macular coloboma was made. Paediatric consultation of the patient was done which was unremarkable. Patient was subjected to laboratory investigations which included IgG and IgM titres for Toxoplasma, Rubella, Cytomegalovirus and Herpes simplex which were negative. Treponema pallidum hemagglutinin test was within normal limits. On the basis of clinical findings and after ruling out differentials, a provisional diagnosis of bilateral pigmented macular coloboma was made. Patient was prescribed glasses and parents were counseled about the poor visual prognosis but patient was lost to follow-up for OCT.
Macular coloboma may be defined as congenital retinochoroidal defect of varying sizes at macular region which manifests as rudimentary or absent retina or choroid at macular region (1),(2). Macular coloboma is a rare disorder with incidence of 0.5-0.7/10,000 live births (3),(4). Both the cases described above were diagnosed as bilateral pigmented macular coloboma (Table/Fig 4) (5). Macular coloboma with excavation at its base on fundoscopy have been reported in literature which was not a feature of this case (6).
There are various conditions that masquerade macular coloboma, namely Leber’s congenital amaurosis, central areolar choroidal atrophy, advanced cone dystrophy, posterior staphyloma and macular scars due to infectious choroiditis (7). These conditions need to be ruled out before establishing a diagnosis of macular coloboma. There was no serological evidence of contact with Toxoplasma gondii in the index cases, thus ruling out congenital toxoplasmosis. Diminution of vision was present since birth 5in both the index cases which is in contrast to central areolar choroidal dystrophy in which case vision would have been normal since late childhood. Also, normal colour vision of the patients in this study rules out possibility of advanced cone dystrophy. Severity of vision loss, associated findings and ophthalmoscopic appearance of the lesion in Case-1 and 2 differentiates it from Leber’s congenital amaurosis. Visual prognosis in macular coloboma is usually poor and improvement is unpredictable (3).
Regarding the pathogenesis, two schools of theories have been proposed in literature for macular colobomas, which include developmental and pathological theories (5). Abnormality of localised part or whole optic cup and primary mesodermal defect are possibilities included in developmental theories while pathological theories indicate that colobomas may be not be truly congenital and may have resulted from intrauterine or infantile choroiditis (5). Macular colobomatous lesions have familial association as reported in literature but no such association was present in Case-1 and 2 (8).
Macular coloboma may co-occur with other systemic and ocular conditions like Down syndrome, familial hypercalciuria, Michaelis-Menz syndrome and short limb dwarfism (9),(10),(11). No systemic association was seen in both the cases in present manuscript. Macular coloboma was found to associated with cataract in a 11-year-old boy where cataract surgery improved visual acuity to some extent (12).
It is of utmost importance to reach at the diagnosis because the treatment strategies vary accordingly. Barrage laser can be considered in colobomas not involving the macula and papillomacular bundle but has a limited role in preserving vision. Low vision rehabilitation services are to be kept in mind during the rehabilitative management. Regular follow-up is of paramount importance. The visual status in index cases discussed in this manuscript remained unchanged which was comparable to similar cases published earlier (4),(5),(6).
Macular coloboma is a rare congenital disorder with poor prognosis. Macular coloboma should be suspected whenever any punched out lesion is noted at macular region. Apart from ophthalmic examination, macular coloboma calls for multi-disciplinary approach for the appropriate management of the associated abnormalities. Such cases should be monitored on regular basis in order to monitor status of visual acuity and fundus for any retinal breaks at the edge of the coloboma.
DOI: 10.7860/JCDR/2023/60961.17843
Date of Submission: Oct 21, 2022
Date of Peer Review: Dec 21, 2022
Date of Acceptance: Mar 07, 2023
Date of Publishing: May 01, 2023
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Oct 31, 2022
• Manual Googling: Jan 12, 2023
• iThenticate Software: Mar 03, 2023 (5%)
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