This application proposes a training plan to develop Jennifer E. Thorne, MD, into a independent clinical scientists , and expert in epidemiologic research methods and clinical trial design. As of December 2001, Dr. Thorne will be a board-certified ophthalmologist with subspecialty training in uveitis and ocular immunology. The Johns Hopkins University is well-suited is well-suited to serve as her training site. The training program will consist of mentored research experience, multi- disciplinary conferences, and courses leading to a PhD in Epidemiology. Mentored research will be conducted as a member of the Studies of Ocular Complications of AIDS (SOCA) Research Group under primary mentor Curtis Meinert, Ph.D., Director of the SOCA Coordinating Center, and co-mentor Douglas A. Jabs, M.D., SOCA Chair. Dr. Thorne will take part in the full spectrum of SOCA Coordinating Center activities, we well as assuming a leading role on the visual outcomes and quality of life (QOL) and Sheila West, Ph.D., a senior ophthalmic epidemiologist, will serve as consultants for this project. Cytomegalovirus (CMV) retinitis complicating AIDS is associated with reduced visual acuity, visual field and quality of life (QOL). LSOCA is a multi-centered prospective cohort study designed to follow patients with AIDS and CMV retinitis over a five year period. Since the advent of highly active anti-retroviral therapy (HAART), the epidemiology of AIDS and CMV retinitis is rapidly evolving. LSOCA seeks to define the incidence of CMV retinitis, the factors that place patients at increased risk for developing CMV retinitis and the sequelae of AIDS-related eye disease in the HAART era. Since therapy for CMV retinitis is driven by maintaining and/or improving visual function and QOL, assessment of these outcomes will play a major role in interpreting the study's results. The primary goals of these sections of the study are to quantify visual loss over time in patients with CMV retinitis, to determine the characteristics that put these patients at high risk for poor visual outcomes, and to evaluate how HAART may affect visual function and QOL outcomes in these patients.
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