The Retina Service at the California Pacific Medical Center has a long and rich history of excellent patient care, teaching, and clinical research. The many volunteer faculty members and departmental leaders have created an environment of curiosity and collaboration that continues to this day.
In the early 1970s the retina service at PMC was a volunteer faculty anchored by Wayne Fung and Gilbert Cleasby. Wallace Friedman, and Blaine Boyden also donated many hours staffing the retina clinics and attending the resident’s retinal surgery cases. As Dr. Bruce Spivey was forming the full-time department, in 1972 he recruited Dr. John Cavender as chief. The most common retinal diseases at that time were retinal detachment, diabetic retinopathy, macular degeneration, and cystoid macular edema. Vitrectomy was introduced at the 1970 AAO meeting in Las Vegas by Robert Machemer and Dr. Fung brought that procedure to the Department after his fellowship at the Bascom Palmer Eye Institute (BPEI) where Dr. Machemer was on the faculty. Dr. Howard Schatz joined the volunteer faculty and later became aligned with UCSF.
Dr. Fung recruited Dr. Arthur (Mike) Allen to join him in private practice at the end of 1977. After finishing his retinal fellowship at BPEI, Allen had first joined the new full-time faculty at the USC/Doheny Eye Institute in Los Angeles consisting of Dr. Steven Ryan, Chairman, Dr. Ronald Smith, and Dr. William Spencer the Medical Director. In the late 1970’s, early ’80’s Drs. Fung and Allen collaborated with UCSF retina specialists, Dr. Alex Irvine and Dr. Walter Stern at the AAO meetings with a course titled “Vitrectomy for the Anterior Segment Surgeon.” Dr. Allen also organized a series of vitrectomy workshops which were widely attended including international physicians during the International Ophthalmology Symposium held in San Francisco in 1982.
In 1982, Dr. Spivey was asked by the Beijing Medical University to send a team of ophthalmologists for a teaching symposium. Dr. Allen arranged to bring vitrectomy equipment and demonstrated its use for the first time in Beijing. Subsequently Dr. Nancy Zhang came to San Francisco to spend a year with Drs. Allen and Fung at Pacific Eye Associates (PEA).
In the late eighties Drs. Fung, Allen and Cavender gave a yearly course at the AAO on Commonly Overlooked or Misdiagnosed Diseases. Dr. Cavender was then recruited to help start a new residency program in Riyadh, Saudi Arabia and later joined the ophthalmology faculty at Dartmouth Medical College.
Dr. Everett Ai, a former CPMC retina fellow, joined the full-time faculty in 1981 after completing additional training in ultrasonography at the University of Iowa and vitreoretinal surgery at Case Western Reserve University in Cleveland, Ohio. Prior to joining the Department, he was an assistant professor and residency program director at the Northwestern University Department of Ophthalmology. During the 1980s, Dr. Ai became an international expert in the management of retinal complications of AIDS, particularly cytomegalovirus (CMV) retinitis. Treatment involved intravitreal injection of antiviral medication, insertion of a sustained release antiviral drug (ganciclovir) delivery implant and, vitrectomy with silicone oil injection for the complex retinal detachment that CMV infection commonly caused. Dr. Ai was an investigator in numerous clinical trials including the important Early Treatment for Diabetic Retinopathy Study and became the medical director of the Ophthalmic Diagnostic Center at CPMC. He also served as the director of the CPMC retina service and vitreoretinal fellowship program until 2003.
Drs. Rich McDonald and Bob Johnson joined Howard Schatz in 1985 and 1989, respectively. Over the years, they worked with many of the CPMC Residents in conducting clinical studies. As their practice grew and became West Coast Retina (WCR), the members became more involved with both the residency and fellowship program. Dr. Mike Jumper has served as the retina service chief from 2003-2013 and again from 2018-present. Dr. Arthur Fu was service chief from 2013-2018. Dr. Sara Haug was a vitreoretinal fellow and later an associate at WCR from 2012-2017. Dr. Anita Agarwal moved from Nashville where she was a Professor of Ophthalmology at Vanderbilt University and joined WCR in 2017. Dr. Judy Chen joined WCR a year later.
The clinical faculty has further expanded with the addition of Dr. Anne Fung, Dr. Jennifer Sung and Dr. Ali Zaidi, all members of Pacific Eye Associates. Dr. Fung has made major contributions to the training program as the director of research.
The retina service faculty have been an integral part of ophthalmology residency training at CPMC since the inception of the program. Many different volunteer attendings have staffed cases in the operating room as well as the Lions Eye Foundation resident retina clinic, including the late Dr. Arthur Fu from 2004-2018. Currently, staffing of resident surgery and clinic is being led by Drs. Anita Agarwal and Judy Chen. Over the years, many residents have gone on to receive fellowship training in vitreoretinal surgery and become retina specialists throughout the United States.
Fellowship training in vitreoretinal diseases and surgery was originally run by Drs. Wayne Fung and Allen, who trained twenty-five fellows between 1970 and 1991. Notable graduates of their program include Dr. Harry Flynn of the Bascom Palmer Eye Institute and Dr. Brooks McCuen who went on to be a surgical innovator at Duke University. Dr. John Norris remained in San Francisco and on the CPMC faculty. Dr. Alan Verne started a practice in the East Bay and became a founding member and leader of the Vitreous Society which later became the American Society of Retinal Specialists, the largest retinal specialty society in the world.
Dr. Everett Ai restarted fellowship training and became director until 2003 when Drs. Rich McDonald and Mike Jumper became co-directors of the program. The 2-year vitreoretinal fellowship training program takes one new fellow each year. The fellows work closely with the residents in the Lions Eye Foundation Clinic as well as the Alameda County Health Care System. The fellowship program is strongly affiliated with West Coast Retina (WCR) and works closely with all of the WCR staff. It is an Association of University Professors in Ophthalmology Fellowship Compliance Committee (AUPO-FCC) compliant program and attracts applicants from the best residency training programs in North America.
Over the years, many department members have been involved with significant clinical research including pivotal clinical trials sponsored by the National Eye Institute including the Early Treatment Diabetic Retinopathy Study (ETDRS), Age-related Eye Disease Study (AREDS2), Collaborative Ocular Melanoma Study, Diabetic Retinopathy Clinical Research Network (DRCR.net), Standard Care vs. Corticosteroid for Retinal Vein Occlusion (SCORE), and Comparison of Anti-VEGF Treatment Trials (CATT). The department has also become a major contributor to industry sponsored clinical research including studies for Roche-Genentech, Novartis, Regeneron, Allergan, and many others.
Many important clinical findings have been documented by faculty members in the area of macular disease, retinal detachment, retinal vascular disease, retinal inflammatory and infectious disease, pediatric retinal disease, and retinal complications of eye. Many residents and fellows have participated and been involved with the publication of these studies.
Leadership in ophthalmology
Faculty members have been leaders in many ophthalmology and retina organizations. Dr. Howard Schatz was a founding member of the Macula Society and Gass Club. Dr. Wayne Fung served as the president of the Retina Society from 1998-1999. Dr. Rich McDonald served as president of the Macula Society from 2018-2019. Dr. Mike Jumper has served many roles at the American Society of Retina Specialists (ASRS) including the editor of the Preferences and Trends Survey, editor-in-chief the Retina Times, and Communications Committee Chair. He currently serves on the ASRS executive committee.