1. As Chair of the DRCR.net, how have you seen research in diabetes-related eye diseases progress in the past 5 to 10 years?
I have seen an evolution from performing individual trials to combining large numbers of clinical sites into a network that has allowed a rapid, efficient way of testing therapies that did not exist previously. Additionally, the pharmaceutical industry has become more involved in funding research in diabetic retinopathy. The result is a collaborative mechanism where clinicians and industry often are working together to test new treatments that likely will change how we manage diabetic retinopathy, and hopefully will allow us to keep our patients from going blind, but in a manner consistent with a clinician's dedication to academic integrity and clinical trial performance.

2. What are the responsibilities required of your position as Chair of the Data and Safety Monitoring Committee for the NEI's intramural clinical trials, and what unique challenges does this position present?
The safety of the individuals who volunteer to participate in clinical trials is the most important responsibility of any safety and monitoring committee. As Chair, I have the pleasure of working with bright and thoughtful people who have experience in almost every aspect of clinical trials, including biostatistics, ethics, and weighing risks and benefits. It is my responsibility to ensure, through advice to the investigators and the NEI, that trials are conducted safely and ethically and that they meet the primary objectives. This includes the interests of currently enrolled human subjects but also includes the interests of patients who potentially could be enrolled in the future and patients outside of these studies.

This position poses unique challenges in that this particular committee is an outside entity overseeing a government-run organization. Usually, for most clinical trials that are sponsored by the National Institutes of Health (NIH), a data and safety monitoring committee monitors participating centers, whether they are university- or community-based practices. This is the reverse situation; these are trials that are being conducted intramurally within the NIH. The government has decided that there should be a committee consisting of individuals outside of the NIH to oversee them. In essence, this committee is charged with monitoring the very government that is providing, in many cases, the most substantial financial support for clinical research.

3. Who are the individuals who have most influenced your career path in ophthalmology?
There are many wonderful people with whom I have crossed paths in my career, but I would have to say that my most important influence is my wife, Susan Bressler, MD. Our careers have mirrored one another's in that we are both ophthalmologists who specialize in retina and we both work in a university-based practice where our interest is in clinical trials. She is my strongest supporter, and at the same time my best critic.

One of the great things about being involved with clinical trials is that you get the opportunity to work with many different and wonderful people, mainly retina specialists, all over the world. Probably among the most significant influences to my work in clinical trials actually are not retina specialists but individuals who have been in charge of coordinating large clinical trials. Barbara Hawkins, former head of the Wilmer Eye Institute's Center for Clinical Trials at Johns Hopkins University, and Roy Beck, MD, PhD, Executive Director of the Jaeb Center for Health Research, are two selfless people who are dedicated to helping us get the answers that change the way physicians conduct daily practice. Their approach to collaborations and their honesty and integrity have had a significant influence on my career.

4. What do you consider to be your greatest achievement?
My greatest accomplishment has been putting my family first. I have always made sure that no matter how hectic my schedule, I am home for dinner. If traveling, I have always tried my hardest to find a way to have my family travel with me. Having a strong family life makes everything else that I do easier and more enjoyable.

I strongly encourage our medical students and residents to do the same. You can build a large retina practice or enjoy a career in research, but you should always make sure that your family is first.

5. What is something that might surprise your colleagues to know about you?
I played clarinet for a long time, and partly, because of my musical background, I am on the board of trustees now for the Interlochen Center for the Arts (Interlochen, MI; www.interlochen.org). Interlochen is a boarding school and summer camp that enrolls brilliant kids from around the country who want to study the arts but may not have access to the resources that one might find in a metropolitan area. This provides kids—like singer-songwriter Josh Groban, or Jewel, who each attended Interlochen—with opportunities that they may not have had otherwise. Although one of my cabinmates went on to become the Concertmaster of the Cleveland Symphony, not all of the students or campers, like myself, go on to careers in the arts—some study law or medicine or become great teachers—but it is still an important experience. Although all of of us in ophthalmology appreciate the impact of vision on our lives, almost everyone experiences a better quality of life each day because of the arts, whether listening to music, watching a movie, or appreciating a print on a calendar or in our waiting rooms.

Being involved with Interlochen's Board of Trustees gives me the opportunity to work with a completely different but equally enjoyable group of people and challenges.