Cynthia A. Toth, MD

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Locations

• Duke Eye Center

Services

• Duke Eye Center

Department / Division:
Ophthalmology / Vitreoretinal Diseases and Surgery Service

Address:
DUMC 3802
Durham, NC 27710

Appointment Telephone:
(919) 681-3937

Office Telephone:
(919) 684-6611

Fax Telephone:
(919) 681-6474

• M.D., Medical College of Pennsylvania, 1983

• Ophthalmology, Geisinger Medical Center, 1984-1987

• Vitreoretinal Diseases and Surgery, University of California-Davis, 1989-1991

Clinical Interests:
Medical and surgical diseases of the retina and vitreous, especially macular diseases, surgical treatments for macular degeneration, retinopathy of prematurity, proliferative vitroeoretinal disorders, retinal detachment and laser eye injury, choroidal neovascular membranes and subretinal hemorrhage, macular translocation surgery

Research Interests:
RESEARCH INTERESTS

Dr. Toth specializes in the evaluation and surgical treatment of vitreoretinal diseases in adults and children. She 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, retinal detachment, proliferative diabetic retinopathy, proliferative vitreoretinopathy (PVR), and retinopathy of prematurity (ROP). She has been repeatedly honored among the Best Doctors in America.

Dr. Toth’s primary research interests include improving diagnostic methods and therapy for macular degeneration and the development and application of Optical Coherence Tomography (OCT) imaging for macular diseases in adults and children. Her Laboratory, the Duke Advanced Research in Spectral Domain OCT Imaging (DARSI) Laboratory centers on improving imaging biomarkers in AMD. Dr. Toth also chairs the Multicenter Age Related Eye Disease Study 2 Ancillary SDOCT (A2ASDOCT) Study. In research in optical coherence tomography (OCT), Dr. Toth is the Director of Grading in the OCT Reading Center at Duke. This center provides support in training, data acquisition, and grading for multicenter clinical trials utilizing optical coherence tomography as an outcome measure. In collaboration with Dr. Joseph Izatt in Biomedical Engineering, Dr. Toth leads the advanced OCT applications program in the Eye Center. This advanced imaging team is currently applying spectral domain OCT (SDOCT) to the study of retinal diseases including AMD in several studies including NIH funded investigation.

Dr. Toth’s clinical research focuses on improving the recovery of vision using macular translocation surgery (MT360) for patients with severe AMD. She heads several ongoing studies of this treatment, 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 are contributing to teasing out the molecular and cellular events in the macula related to vision loss and from which we will develop therapies to better reverse the loss.

Representative Publications:
Walton KA, Meyer CH, Harkrider CJ, Cox TA, Toth CA. Age-related changes in vitreous mobility as measured by video B scan ultrasound. Exp Eye Res. 2002 Feb;74(2):173-80. (2002) Abstract

Toth CA, Lapolice DJ, Banks AD, Stinnett SS. Improvement in near visual function after macular translocation surgery with 360-degree peripheral retinectomy. Graefes Arch Clin Exp Ophthalmol. 2004 Jul;242(7):541-8. (2004) Abstract

Toth CA, Morse LS, Hjelmeland LM, Landers MB 3rd. Fibrin directs early retinal damage after experimental subretinal hemorrhage. Arch Ophthalmol. 1991 May;109(5):723-9. (1991) Abstract

Mruthyunjaya P, Stinnett SS, Toth CA. Change in visual function after macular translocation with 360 degrees retinectomy for neovascular age-related macular degeneration. Ophthalmology. 2004 Sep;111(9):1715-24. (2004) Abstract

Toth CA, Freedman SF. Macular translocation with 360-degree peripheral retinectomy impact of technique and surgical experience on visual outcomes. Retina. 2001;21(4):293-303. (2001) Abstract

Ting TD, Oh M, Cox TA, Meyer CH, Toth CA. Decreased visual acuity associated with cystoid macular edema in neovascular age-related macular degeneration. Arch Ophthalmol. 2002 Jun;120(6):731-7. (2002) Abstract

Cahill MT, Stinnett SS, Banks AD, Freedman SF, Toth CA. Quality of life after macular translocation with 360 degrees peripheral retinectomy for age-related macular degeneration. Ophthalmology. 2005 Jan;112(1):144-51. (2005) Abstract

Cahill MT, Banks AD, Stinnett SS, Toth CA. Vision-related quality of life in patients with bilateral severe age-related macular degeneration. Ophthalmology. 2005 Jan;112(1):152-8. (2005) Abstract

Gallemore RP, Jumper JM, McCuen BW 2nd, Jaffe GJ, Postel EA, Toth CA. Diagnosis of vitreoretinal adhesions in macular disease with optical coherence tomography. Retina. 2000;20(2):115-20. (2000) Abstract

Roach WP, Cain CP, Narayan DG, Noojin GD, Boppart SA, Birngruber R, Fujimoto JG, Toth CA. Retinal response of Macaca mulatta to picosecond laser pulses of varying energy and spot size. J Biomed Opt. 2004 Nov-Dec;9(6):1288-96. (2004) Abstract

Park CH, Toth CA. Macular translocation surgery with 360-degree peripheral retinectomy following ocular photodynamic therapy of choroidal neovascularization. Am J Ophthalmol. 2003 Nov;136(5):830-5. (2003) Abstract

Mruthyunjaya P, Stinnett SS, Toth CA. Impact of fluorescein angiographic characteristics of macular lesions on outcomes after macular translocation 360 degree surgery in eyes with age-related macular degeneration. Retina. 2005 Jul-Aug;25(5):597-607. (2005) Abstract

Hawkins BS, Bressler NM, Bressler SB, Davidorf FH, Hoskins JC, Marsh MJ, Miskala PH, Redford M, Sternberg P Jr, Thomas MA, Toth CA, . Surgical removal vs observation for subfoveal choroidal neovascularization, either associated with the ocular histoplasmosis syndrome or idiopathic: I. Ophthalmic findings from a randomized clinical trial: Submacular Surgery Trials (SST) Group H Trial: SST Report No. 9. Arch Ophthalmol. 2004 Nov;122(11):1597-611. (2004) Abstract

Toth CA. Macular degeneration: the latest in current surgical management. Retina. 2006 Jul-Aug;26(6 Suppl):S21-5. (2006) Abstract

Cahill MT, Mruthyunjaya P, Bowes Rickman C, Toth CA. Recurrence of retinal pigment epithelial changes after macular translocation with 360 degrees peripheral retinectomy for geographic atrophy. Arch Ophthalmol. 2005 Jul;123(7):935-8. (2005) Abstract

Malek G, Johnson LV, Mace BE, Saloupis P, Schmechel DE, Rickman DW, Toth CA, Sullivan PM, Bowes Rickman C. Apolipoprotein E allele-dependent pathogenesis: a model for age-related retinal degeneration. Proc Natl Acad Sci U S A. 2005 Aug 16;102(33):11900-5. (2005) Abstract

Toth CA, Narayan DG, Boppart SA, Hee MR, Fujimoto JG, Birngruber R, Cain CP, DiCarlo CD, Roach WP. A comparison of retinal morphology viewed by optical coherence tomography and by light microscopy. Arch Ophthalmol. 1997 Nov;115(11):1425-8. (1997) Abstract

Meyer CH, Toth CA. Retinal pigment epithelial tear with vitreomacular attachment: a novel pathogenic feature. Graefes Arch Clin Exp Ophthalmol. 2001 Jun;239(5):325-33. (2001) Abstract

Toth CA, Birngruber R, Boppart SA, Hee MR, Fujimoto JG, DiCarlo CD, Swanson EA, Cain CP, Narayan DG, Noojin GD, Roach WP. Argon laser retinal lesions evaluated in vivo by optical coherence tomography. Am J Ophthalmol. 1997 Feb;123(2):188-98. (1997) Abstract