This is a proposal to develop the staff and resources needed to enhance programs of clinical vision research at the Massachusetts Eye and Ear Infirmary (MEEI). It will provide epidemiologic resources for clinical investigators at a needed level which is not now available. This support will strengthen epidemiological-clinical interactions of investigators at MEEI so they may participate and provide leadership in the design, coordination and conduct of clinical investigations including clinical trials and both prospective and retrospective evaluations of risk factors for disease development and progression. The epidemiologist will be integrated as a collaborator, and it is expected that by the end of this award period the epidemiologist will be supported by several funded projects. An epidemiologist with knowledge and experience in the study of eye diseases has been identified. He would become a member of the clinical research team and would begin new initiatives in the design, execution and analyses of research projects involving investigators at MEEI. He would be supported by a part-time statistical programmer who would have a masters degree in epidemiology or biostatistics. Projects of high program relevance to the NEI which the epidemiologist would help to carry out include the following subjects: ultraviolet damage and nutrition in eye disease, therapy for macular edema in uveitis, ocular trauma, open angle glaucoma, anterior ischemic optic neuropathy, and retinoblastoma. Study designs tentatively proposed for these investigations include clinical trials, case-control studies and followup studies. A clinical research seminar series will be initiated to indoctrinate clinicians into clinical trial methodology and other aspects of clinical research, and to foster collaborations. The epidemiologist and programmer would be a resource for other investigators at MEEI as they develop their studies in clinical vision research. There are numerous opportunities for clinical research at MEEI and a core group of clinical investigators interested in carrying out these projects. Feasibility of these projects and the overall program requires support for an epidemiologist. Institutional support of this project and its importance is indicated by a commitment of personnel, time, space and other resources.
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