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Volume 43, 1993, p. 115124

AIDS: The St. Paul's Experience Part I: The Ophthalmologist's Role (Abstract)
D. P. Anderson, M.D., P. A. Nash, M.D., J. I. Lindley, M.D., S. P. Holland, M.D.


St. Paul's Hospital is a major teaching hospital of the University of British Columbia and has been the main referral center for HIV related diseases since the epidemic began. In 1987, St. Paul's Hospital established a multi-disciplinary, research-oriented AIDS clinic that now cares for 75% of all AIDS patients in the province of British Columbia. St. Paul's Hospital/University of British Columbia is the administrative headquarters of the Canadian HIV clinical trials network. It is also the site of the British Columbia Centre for Excellence in HIV/AIDS.


The pathophysiology and epidemiology of HIV are reviewed. Specific risk factors are outlined. Examples of the natural history of cytomegalovirus (CMV) retinitis as seen by the ophthalmologist with and without treatment are given. Preventative strategies and directions of future research are outlined.


Three hundred and forty-five HIV+ positive patients attending the Infectious Eye Disease Clinic between January 1, 1990 and March 31, 1992 were reviewed. CMV retinitis occurred in 99 patients (29%) and was the most serious visual disorder. Forty-seven of the 99 patients with CMV retinitis are deceased. Eighty-one percent of these patients retained useful vision until death. Of the 52 remaining patients, 88% are retaining useful vision.


The Infectious Eye Disease Clinic is an important part of the network of physicians, nurses, and technical staff at St. Paul's Hospital who provide care for AIDS patients.