Dr. Toth specializes in the evaluation and surgical treatment of vitreoretinal diseases in adults and children and has pioneered the development of macular translocation surgery for age-related macular degeneration (AMD). Her particular clinical interests and skills also include the surgical treatment of macular diseases (such as, macular hole, epiretinal membrane and vitreomacular traction), retinal detachment, proliferative diabetic retinopathy, proliferative vitreoretinopathy (PVR), and retinopathy of prematurity (ROP). She is a world expert in retinal imaging with optical coherence tomography (OCT) and pioneered both the first use of a research hand-held spectral domain OCT system for infant examination and a novel intraoperative real-time swept source OCT-guided ophthalmic surgical system. With the pediatric system, her multidisciplinary team has demonstrated novel eye-brain linkage during preterm development. Dr. Toth performed the world's first intraoperative swept-source OCT imaging with heads-up display during macular surgery and is perfecting such techniques. She has been repeatedly honored among the Best Doctors in America.
Dr. Toth is also professor in the Department of Biomedical Engineering in the Pratt School of Engineering (fds.duke.edu/db/pratt/BME/faculty/cynthia.toth). Her primary research interests are in translational research and early-application clinical trials with a focus on novel retinal imaging with spectral domain and swept source optical coherence tomography (SD and SSOCT). Dr. Toth's Laboratory, the Duke Advanced Research in Spectral Domain OCT Imaging (DARSI) Laboratory centers on improving early diagnostic methods, imaging biomarkers and therapies for both age-related macular degeneration (AMD) and for retinal diseases in children. Sina Farsiu, PhD,(www.duke.edu/~sf59/) provides expertise in advanced image processing for SDOCT in the DARSI Laboratory. In collaboration with Joseph Izatt, Ph.D. (fds.duke.edu/db/pratt/BME/faculty/joseph.izatt) in Biomedical Engineering, the DARSI team is currently applying SD and SSOCT to the care of retinal diseases and especially in microsurgery in adults and in children in several studies including NIH funded investigations.
In research in optical coherence tomography (OCT),Dr. Toth was co-founder and is the Director of Grading for OCT for the Duke Reading Center (www.dukeoct.org/index_html) and has designed and directed OCT analysis for many multicenter clinical trials. This center provides support in training, data acquisition, and grading for multicenter clinical trials utilizing optical coherence tomography as an outcome measure.
Dr. Toth chairs the Multicenter Age Related Eye Disease Study 2 Ancillary SDOCT (A2ASDOCT) Study. She also directed studies of macular translocation surgery (MT360) for patients with severe AMD, along with her co-investigator Dr. Sharon Freedman. Macular translocation surgery is not only a salvage treatment for AMD patients who lose vision despite other therapies, but it is a unique way to isolate the retina for study separate from underlying pathology. Imaging and retinal function data have contributed to teasing out events in the macula related to vision loss.