This application is for a computer to expand our clinical research of a variety of diseases and problems that contribute to significant visual loss for Americans. The Wilmer Institute opened its Computer Center in 1976 to service all of its many-faceted research projects. An IBM 11/45 running under the UNIX operating systems sufficed for about 10 yrs. It was finally replaced by a VAX 11/750; the current system. Meanwhile, demand for computer useage has grown exponentially. Most of the growth is related to management of large patient data-bases in longitudinal studies with eye diseases and their treatment. An example of this is the Clinical Trial in which one tests the hypothesis that a certain treatment of disease is beneficial in the long run. This can require about 2,000 patients be studied requiring collaboration between medical schools throughout the country with one acting as Coordinating Center. Some patients will be treated one way, some another. Are patients are followed for years and the date can easily consist of 2,000 pieces of information per patient. Statistical analysis is important in the initial design of the Trial and data analysis is constantly needed to monitor progress, but the main use of the computer is in administration and management of the Trial: recalling patients, checking protocol completeness, and a thousand other details. Our first Clinical Trial, and our most famous to date, concerned the use of lasers to coagulate abnormal growth of blood vessels in age-related macular degeneration-a major cause of vision loss in older Americans. This massive Clinical Trial, begun in 1979, had shown by 1982, that laser treatment was an obvious success. Since then, with the enthusiastic support of the National Eye Institute, other Clinical Trials, as well as Natural History and Genetic Studies, have evolved in Wilmer bearing on such eye problems as ocular melanoma, corneal transplantation, glaucoma, optic neuritis, juvenile diabetes, intraocular lens implantation, retinitis pigmentosa, the Marfan syndrome and congenital esotropia. This rapid growth has simply swamped the Computer Center. Current work is now seriously impeded, and contemplated expansion of these projects and the additions of new ones will be impossible without expanded computer power. We feel that supplementing our system with a Pyramid 9815 Supermini-Computer will break this bottleneck and permit our planned expanded research for at least the next ten years.
