Dr. Cynthia Toth MD

Practice: Duke Eye Center

Location: Durham, North Carolina

Website: http://dukeeyecenter.duke.edu/

Phone: 919-684-5631

Email: cynthia.toth@duke.edu

Dr. Toth specializes in the evaluation and surgical treatment of vitreoretinal diseases in infants, children and adults, and in novel research resulting in the clinical application of optical coherence tomography (OCT) imaging in surgery and at the bedside. Her clinical interests and skills 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).

Dr. Toth 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 the first intraoperative OCT-guided ophthalmic surgical system. For infants and children, Dr. Toth's multidisciplinary team has demonstrated novel eye findings that are visible only with OCT imaging and that are often associated with brain disease or challenges of brain development. In surgery, Dr. Toth performed the world's first intraoperative OCT imaging and the first swept-source OCT imaging with heads-up display during retinal surgery. With colleagues in the Duke Eye Center and in Biomedical Engineering, she 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. 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/Swept Source 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, has collaborated to provide advanced image processing for OCT with in the DARSI Laboratory. In collaboration with Joseph Izatt, PhD in Biomedical Engineering, the DARSI team is currently applying OCT to the diagnosis and care of retinal diseases and especially in microsurgery in adults and in children in several studies including NIH funded investigations.

Dr. Toth was also co-founder and has been the Director of Grading for OCT for the Duke Reading Center and has designed and directed OCT analysis for numerous multicenter clinical trials including the Comparisons of AMD Treatment Trials (CATT). The Duke Reading Center provides support in training, data acquisition, and grading for multicenter clinical trials utilizing optical coherence tomography as an outcome measure.

Dr. Toth chaired the multicenter Age Related Eye Disease Study 2 Ancillary SDOCT (A2ASDOCT) Study and has participated as site PI in the AREDS2. She also led studies of macular translocation surgery (MT360) for patients with severe AMD, along with co-investigator Dr. Sharon Freedman. Macular translocation surgery was a salvage treatment for AMD patients who lost vision due to neovascular AMD, prior to the current era of anti-Vascular Endothelial Growth Factor treatments. The surgery resulted in an auto-transplant of the retina, isolating the retina from the underlying choroidal and retinal pigment epithelial pathology. Imaging and retinal function data from those studies have contributed to teasing out events in the macula related to vision loss.

    • Ophthalmology - University of California, Davis, School of Medicine

    • Ophthalmology - Geisinger Medical Center

    • M.D. 1983 - Drexel University

FAQ

At the Jack McGovern Coats’ Disease Foundation, we are often contacted by anxious parents or patients who are seeking information after receiving a diagnosis of Coats’ Disease. The questions below are provided as a resource to assist you as you and your doctor decide the best approach for treatment. These questions do not constitute any form of medical advice or diagnosis. Each patient is unique. An experienced retinal specialist who has examined the patient is the best source of information for diagnosis and treatment. We always recommend getting a second opinion.

Questions to Ask Your Doctor (Download PDF)

  • Ahead of any treatments or procedures, it is important to ask yourself and the doctor the following questions:

    • How do you know that this is Coats’ Disease?

    • Has your doctor treated other patients with Coats’ Disease?

    • Have you sought a second opinion? If not, please consult our Doctor Directory for knowledgeable doctors in your area.

    • What Stage of Coats’ Disease is he/she in?

    • Will his/her vision get worse over time?

    • Will the eye have pain?

    • Will his/her eye start to turn out? Is muscle corrective surgery an option?

    • Are cataracts likely?

    • How likely is glaucoma? (due to retinal detachment)

    • Is there calcification?

    • What is the anticipated disease progression?

    • Is there a thorough vision exam available?

    • Where is the vision affected? (central/peripheral/distance)

    • Does he/she have depth perception? (3D visibility)

    • What about the non-Coats’ eye?

    • To what extent is his/her vision affected?

    • Will we be able to use this as a baseline to measure progress/decline?

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