fcrsff iliatlonal 1 ANNUAL REPORT OF PROGRAM ACTIVITIES NATIONAL EYE INSTITUTE Fiscal Year 1974 KB TABLE OF CONTENTS Page STATEMENT OF THE INSTITUTE DIRECTOR 1 INTRAMURAL RESEARCH 3 REPORT OF THE DIRECTOR OF INTRAMURAL RESEARCH 5 Clinical Branch 7 Report of the Clinical Director 9 Ballintine, Elmer J., M.D. Ocular Hypertension Study 11 Aqueous Humor Formation in Monkeys 13 Bergsma, Donald R. , M.D. Studies of Choroidal-Retinal Degenerative Diseases 15 Studies of Ophthalmic Familial and Genetic Diseases 17 Charles, Steve, M.D. Development of Improved Instrumentation for Vitreous Surgery 19 Eichenbaum, Daniel M. , M.D. Combined Clinical and Experimental Animal Study of the Pathogenesis of Abnormal Proliferations in the Vitreous Cavity 21 Foon, Kenneth, M.D. Inheritance of Susceptibility to Lymphocyte Transformation Inhibition 23 Frank, Robert N. , M.D. Argon Laser Photocoagulation of Retinal and Choroidal Diseases 25 Biochemistry of Vertebrate Retinal Receptor Outer Segments 29 Gaasterland, Douglas E., M.D. Study of the Use of Radioiodinated (1-125) Chloroquine Analog for the Differential Diagnosis and Detection of Intraocular Melanoma 33 Experimental Glaucoma in the Rhesus Monkey 35 Gunkel, Ralph D., O.D. Design and Construction of Ophthalmic Instruments; Research in Methods of Evaluating Visual Processes 39 Clinical Branch (cont.) Page Kolb, Helga, Ph.D. Anatomy and Pathology of the Mammalian Retina 41 Kupfer, Carl, M.D. Studies of Parameters of Intraocular Pressure 43 Maori, Frank J., Ph.D. Study on the Pharmacodynamics of Various Agents Affecting the Intraocular Pressure 47 Ross, Karyn Ciliary Body Blood Flow and Aqueous Humor Formation in the Rhesus Monkey 51 Sullivan, William R. , M.D. Comparative Treatment of Bullous Keratopathy with the Bausch and Lomb "Soflens" and the American Optical "Bandage" Soft Contact Lenses 53 Studies of the Effect of Histocompatibility (HL-A) Testing and Corneal Transplantation 55 Treatment of Keratoconjunctivitis Sicca with N-acetyl- 1-cysteine 57 Laboratory of Vision Research 59 Report of the Chief 61 Section on Biochemistry Kinoshita, Jin H. , Ph.D. Chemistry and Metabolism of the Lens 63 Cataracts 67 Chader, Gerald J., Ph.D. Biochemical Development and Function of Retina and Pigmented Epithelium 71 Cyclic Nucleotides and Vision 73 Helmsen, Ralph J., Ph.D. Induction of Buphthalmos in Chicks by Feeding a High Level of Glycine 75 Chemistry of the Cornea 77 Mechanism of Herpes Simplex Virus Infection of Corneal Cells 79 Hess, Helen H. , M.D. Biochemical Composition of Photoreceptor, Neuronal and Glial Cells of Normal and Pathological Retina and Brain 81 11 ) Laboratory of Vision Research (cont.) Page Section on Biochemistry (cont . Lewis, Marc S., Ph.D. Chemistry of Rhodopsin 85 Physical Chemistry of Model Gel Systems 89 O'Brien, Paul, J., Ph.D. Synthesis of Sugar-Containing Polymers in Retina 91 Protein Synthesis in the Retina 93 Shichi, Hitoshi, Ph.D. Biochemistry of Visual Pigments 95 Yoshikami, S. , Ph.D. Photoexcitatory Processes in Visual Cells 99 Section on Experimental Embryology Coulombre, A. J., Ph.D. Ocular Morphogenesis 103 Section on Experimental Pathology Kuwabara, Toichiro, M.D. Anatomic and Pathologic Studies of Ocular Tissue 107 Effect of Laser on the Retina 111 Light Effect on the Retina 113 Okisaka, Shigekuni, M.D. Effect of Intraocular Pressure on the Ciliary Epithelium 115 Robison, W. Gerald, Jr., Ph.D. The Functions of Cell Microtubules and Microfilaments in Ocular Tissues 117 Ultrastructure and Function of the Pigment Cells of the Eye 119 Section on Neurophysiology Gouras, Peter, M.D. Physiology of the Primate Visual System 121 Dow, Bruce M. , M.D. Information Processing in the Visual Cortex of the Rhesus Monkey 125 Nelson, Ralph, Ph.D. Electrophysiological Studies of Mammalian Retina 127 111 Page OFFICE OF BIOMETRY AND EPIDEMIOLOGY 131 Report of the Chief 133 Office of the Chief Kahn, Harold A. The Model Reporting Area for Blindness Statistics (MRA) 135 National Health and Nutrition Survey 137 Framingham Eye Study 139 Comparison of Localized Treatments for Bilateral Disease 141 Ganley, James P., M.D., Dr.P.H. Systemic and Ocular Onchocerciasis 143 Lymphocyte Transformation Response in Presumed Ocular Histoplasmosis 145 Section on Clinical Trials and Natural History Studies 147 Ederer , Fred Statistical Consultation, Collaborative Diabetic Retinopathy Study 149 Assessment of Evidence on the Value of Photocoagu- lation in Treating Diabetic Retinopathy 153 AUPO Workshop on Clinical Trials 155 Patient Bias, Investigator Bias, and the Double- Masked Procedure 157 Confidence Limits on the Ratio of Two Poisson Variables 159 Section on Mathematical Statistics and Computer Applications 161 Milton, Roy C. , Ph.D. Statistical Summary of Dark Adaptation and Retinal Function Clinical Data 163 Ganley, James P., M.D., Dr.P.H. Accuracy and Repeatability of Reading Fundus Photographs 165 Hiller, Rita Prevalence, Incidence and Economic Cost of Eye Disease in the U.S. 167 Kahn, Harold A. Bayesian Statistical Theory and Methods: A Critical Study 169 IV ) Page OFFICE OF BIOMETRY AND EPIDEMIOLOGY (cont . Section on Ophthalmic Field and Developmental Research 171 Schwartz, J. Theodore, M.D. Twin Register for Eye Examinations (TREE) 175 Effect of Treatment on the Progression of Myopia 177 Methodology of Twin Heritability Studies 179 The Influence of Methodologic Differences on Measurements of Cup/Disc Ratio 181 Frequency Distribution of Horizontal Cup/Disc Ratio and Relationship Between Cup Size and Other Clinical Variables 183 Association Between the Ocular Hypertensive Response to Topical Dexamethasone and Other Clinical and Laboratory Measurements 185 Twin Study on the Inheritance of Normal Levels of Intraocular Pressure 187 Twin Heritability Study of Horizontal Cup/Disc Ratio in Normal Eyes 189 Reuling, Frank H. , M.D. Heritability of the Effect of Corticosteroids on Intraocular Pressure 191 Contract Narrative—Etiology of Diabetic Retinopathy 193 Steroid Induced Glaucoma 195 OFFICE OF SCIENTIFIC REPORTS AND PROGRAM PLANNING COORDINATION 197 EXTRAMURAL AND COLLABORATIVE PROGRAMS 203 Statement of the Associate Director 205 RETINAL AND CHOROIDAL DISEASES 209 CORNEA 223 CATARACT 231 GLAUCOMA 237 SENSORY-MOTOR DISORDERS AND REHABILITATION 249 Contract Narrative—Development of Drugs Useful in the Treatment of Glaucoma and their Evaluation in Animals and Man 273 Evaluation of the Effectiveness of Diphenylhydantoin (DPH) in Reversal of Recent Glaucomatous Field Defects 275 Study and Improvement of Surgery on the Outflow Channels in Glaucoma Eyes 277 Page EXTRAMURAL AM) COLLABORATIVE PROGRAMS (cont.) Contract Narrative—Development of a Non-Invasive Sensing System to Measure Intraocular Pressure Continuously 279 Small Scale Test Procedure on the Reliability and Visability of Observing Nerve Fiber Bundle Defects as an Early Diagnostic Procedure for Visual Field Defects 281 Evaluation of Indicator Substances for Use in the Study of the Retinal and Choroidal Circulation 283 Development of a Clinically Useful, Objective, Photographic Technique for Fluorescein Angiography (GWU) 285 Development of a Clinically Useful, Objective, Photographic Technique for Fluorescein Angiography (Whittaker) 287 Development of the RCS Rat as a Model of Hereditary Degenerative Diseases of the Retina 289 VI ANNUAL REPORT NATIONAL EYE INSTITUTE July 1, 1973 - June 31, 197A STATEMENT OF THE INSTITUTE DIRECTOR Progress against leading causes of blindness and visual disability in the United States is highlighted in this report of research conducted and supported by the National Eyp Institute during FY 1974. Now in its fifth year, the NEI has formally begun to take stock of past accomplishments, assess the comprehensiveness and effectiveness of its current program, and document the requirements for the future development of vision research support. Preliminary analysis of three of its five major programs by a Program Planning Subcommittee of the National Advisory Eye Council has shown that although balance in these programs is generally good, there is need for greater emphasis in certain key areas of research in order to hasten the development of knowledge which can be applied to the improved prevention, diagnosis, and treatment of visual disorders. In addition, the support of manpower training must be maintained and increased in order to sustain the high level of achievement that characterizes vision research in this country today. Without a consistent program of train- ing support, the research momentum gained through thp creation of the Eye Institute will be inevitably slowed. Continued emphasis on the support of quality laboratory research, appli- cation of epidemiological techniques to eye disease problems, and stimulation of additional clinical research, particularly in retinal and choroidal dis- orders, will help provide the scientific base upon which more effective vision care and eye disease prevention programs can be built. In this manner, the National Eye Institute approaches its goal of reducing the enormous toll in human suffering and economic loss taken each year in our nation by blindness and visual disability. / > » INTRAMURAL RESEARCH c ANNUAL REPORT NATIONAL EYE INSTITUTE July 1, 1973 - June 31, 1974 REPORT OF THE DIRECTOR OF INTRAMURAL RESEARCH Carl Kupfer, M.D. Although the National Eye Institute's Intramural Program will always constitute only a modest portion of the nation's total vision research effort, its continued development is crucial, not only for direct research activities, but for the evolution