Cynthia A. Toth, MD

Joseph AC Wadsworth Professor of Ophthalmology and Professor of Biomedical Engineering, Pediatric Retina Specialist and Surgeon

Dr. Toth is a clinician-scientist and vitreoretinal surgeon caring for infants, children and adults with retinal diseases that affect vision. She studies new methods of bedside and surgical imaging, especially optical coherence tomography (OCT) for better assessment and management of infant and child eye and brain disease. Dr. Toth obtained her medical degree from The Medical College of Pennsylvania, completed Ophthalmology residency at Geisinger Medical Center, and fellowship in Medical and Surgical Diseases of the Retina and Vitreous at the University of California at Davis. Before joining the Duke faculty in 1993, Dr. Toth served on active duty in the US Air Force, heading the Retina Division at the USAF Medical Center in San Antonio. While there, she performed groundbreaking OCT research with Prof. James Fujimoto and William P. Roach, PhD. She brought this expertise and technology to Duke.

Along with Dr. Sharon Freedman, Dr. Mays El Dairi and Dr. Lejla Vajzovic, Dr. Toth formed the Duke Pediatric Retina and Optic Nerve Center. The development of the neural tissue of the retina has received limited attention in large part because of the multitude of technical challenges in studying eye development and the connection to brain development in the small eyes of newborn infants.

Dr. Toth recognized that lack of advancement in imaging for infants and spearheaded bringing OCT technology to children. Through funding from Duke’s Clinical Translational Science Award, The Hartwell Foundation Research Award, and The Andrew Family Charitable Foundation, Dr. Toth developed methods for portable bedside OCT imaging of the eyes of awake infants. The FDA subsequently cleared such a portable unit for infant imaging. Dr. Toth’s team was the first to demonstrate the in vivo progress of subcellular retinal maturation, abnormalities in development and to link the delay in development with neurodevelopmental delay at age 2 years. The team is multidisciplinary and includes neonatologists, neuroradiologists, child development specialists and pediatric ophthalmologists to investigate the developing eye-brain connection in premature infants. Her eye-brain discoveries in infants lead toward a new era where bedside imaging of the eye will aid in early identification of the infant at risk for neurodevelopmental and vision problems and in monitoring response to interventions.


Representative Publications

1. Maldonado RS, O'Connell RV, Sarin N, Freedman SF, Wallace DK, Cotten CM, Winter KP, Stinnett S, Chiu SJ, Izatt JA, Farsiu S, Toth CA. Dynamics of Human Foveal Development after Premature Birth. Ophthalmology. 2011 Dec; 118(12):2315-25. Epub 2011 Sep 21. PMCID: 3496560

2. Maldonado RS, O'Connell RV, Ascher SB, Sarin N, Freedman SF, Wallace DK, Chiu SJ, Farsiu S, Cotten M, Toth CA. Spectral-Domain Optical Coherence Tomographic Assessment of Severity of Cystoid Macular Edema in Retinopathy of Prematurity. Arch Ophthalmol. 2012 May;130:569-78.

3. Vajzovic L, Hendrickson AE, O’Connell RV, Clark LA, Tran-Viet D, Possin D, Chiu SJ, Farsiu S, Toth CA. Maturation of the Human Fovea: Correlation of Spectral-Domain Optical Coherence Tomography Findings With Histology. Am J Ophthalmol. 2012 Nov; 154:779-789.

4. Rothman AL, Tran-Viet D, Gustafson KE, Goldstein RF, Maguire MG, Tai V, Sarin N, Tong AY, Huang J, Kupper L, Cotten CM, Freedman SF, Toth CA. Poorer Neurodevelopmental Outcomes Associated with Cystoid Macular Edema Identified in Preterm Infants in the Intensive Care Nursery. Ophthalmology. 2015 Mar;122:610-9.

5. Vajzovic L, Rothman AL, Tran-Viet D, Cabrera MT, Freedman SF, Toth CA. Delay in retinal photoreceptor development in very preterm compared to term infants. Invest Ophthalmol Vis Sci. 2015 Jan 13;56:908-13.