1. Cynthia A. Toth

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    1. Mentioned In 111 Articles

    2. Four-dimensional microscope- integrated optical coherence tomography to enhance visualization in glaucoma surgeries

      Four-dimensional microscope- integrated optical coherence tomography to enhance visualization in glaucoma surgeries
      We report the first use of swept-source microscope-integrated optical coherence tomography (SS-MIOCT) capable of live four-dimensional (4D) (three-dimensional across time) imaging intraoperatively to directly visualize tube shunt placement and trabeculectomy surgeries in two patients with severe open-angle glaucoma and elevated intraocular pressure (IOP) that was not adequately managed by medical intervention or prior surgery. We performed tube shunt placement and trabeculectomy surgery and used SS-MIOCT to visualize and record surgical ...
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    3. Review of intraoperative optical coherence tomography: technology and applications [Invited]

      Review of intraoperative optical coherence tomography: technology and applications [Invited]
      During microsurgery, en face imaging of the surgical field through the operating microscope limits the surgeons depth perception and visualization of instruments and sub-surface anatomy. Surgical procedures outside microsurgery, such as breast tumor resections, may also benefit from visualization of the sub-surface tissue structures. The widespread clinical adoption of optical coherence tomography (OCT) in ophthalmology and its growing prominence in other fields, such as cancer imaging, has motivated the development ...
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    4. Four-dimensional Microscope-Integrated Optical Coherence Tomography to Visualize Suture Depth in Strabismus Surgery

      Four-dimensional Microscope-Integrated Optical Coherence Tomography to Visualize Suture Depth in Strabismus Surgery
      The authors report the use of swept-source microscope-integrated optical coherence tomography (SS-MIOCT), capable of live four-dimensional (three-dimensional across time) intraoperative imaging, to directly visualize suture depth during lateral rectus resection. Key surgical steps visualized in this report included needle depth during partial and full-thickness muscle passes along with scleral passes.
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    5. Optical Coherence Tomography Reflective Drusen Substructures Predict Progression to Geographic Atrophy in Age-related Macular Degeneration

      Optical Coherence Tomography Reflective Drusen Substructures Predict Progression to Geographic Atrophy in Age-related Macular Degeneration
      Purpose Structural and compositional heterogeneity within drusen comprising lipids, carbohydrates, and proteins have been previously described. We sought to detect and define phenotypic patterns of drusen heterogeneity in the form of optical coherence tomographyreflective drusen substructures (ODS) and examine their associations with age-related macular degeneration (AMD)related features and AMD progression. Design Retrospective analysis in a prospective study. Participants Patients with intermediate AMD (n = 349) enrolled in the multicenter Age-Related ...
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    6. Needle Depth and Big-Bubble Success in Deep Anterior Lamellar Keratoplasty: An Ex Vivo Microscope-Integrated OCT Study

      Needle Depth and Big-Bubble Success in Deep Anterior Lamellar Keratoplasty: An Ex Vivo Microscope-Integrated OCT Study
      Purpose: To examine big-bubble (BB) formation success rates in deep anterior lamellar keratoplasty (DALK) at various corneal depths using real-time guidance from swept-source, microscope-integrated optical coherence tomography (SS-MIOCT). Methods: The DALK procedure was performed ex vivo with 34 human donor corneoscleral buttons on pressurized artificial anterior chambers using the BB technique employed by Anwar and Teichmann. We inserted a needle under controlled ex vivo conditions to corneal depths ranging from ...
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    7. Live volumetric (4D) visualization and guidance of in vivo human ophthalmic surgery with intraoperative optical coherence tomography

      Live volumetric (4D) visualization and guidance of in vivo human ophthalmic surgery with intraoperative optical coherence tomography
      Minimally-invasive microsurgery has resulted in improved outcomes for patients. However, operating through a microscope limits depth perception and fixes the visual perspective, which result in a steep learning curve to achieve microsurgical proficiency. We introduce a surgical imaging system employing four-dimensional (live volumetric imaging through time) microscope-integrated optical coherence tomography (4D MIOCT) capable of imaging at up to 10 volumes per second to visualize human microsurgery. A custom stereoscopic heads-up ...
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    8. Spectral domain optical coherence tomography (SD-OCT) Imaging of the Vascular-Avascular junction in the nursery in infants with retinopathy of prematurity

      Spectral domain optical coherence tomography (SD-OCT) Imaging of the Vascular-Avascular junction in the nursery in infants with retinopathy of prematurity
      Since the publication of Foos, there has been little additional microanatomic data on the vascular-avascular junction in retinopathy of prematurity (ROP) in infants. We hypothesize that one could view retinal development across the vascular-avascular (V-AV) junction in infants with ROP using portable bedside SDOCT imaging and novel image analysis.
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    9. Impact of Microscope-Integrated OCT on Ophthalmology Resident Performance of Anterior Segment Surgical Maneuvers in Model Eyes

      Impact of Microscope-Integrated OCT on Ophthalmology Resident Performance of Anterior Segment Surgical Maneuvers in Model Eyes
      Purpose : The integration of swept-source optical coherence tomography (SS-OCT) into the operating microscope enables real-time, tissue-level three-dimensional (3D) imaging to aid in ophthalmic microsurgery. In this prospective randomized controlled study, we evaluated the impact of SS microscope-integrated OCT (MI-OCT) on ophthalmology residents' performance of ophthalmic microsurgical maneuvers. Methods : Fourteen ophthalmology residents from a single institution were stratified by year of training and randomized to perform four anterior segment surgical maneuvers ...
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    10. Optical Coherence Tomography for Retinal Surgery: Perioperative Analysis to Real-Time Four-Dimensional Image-Guided Surgery

      Optical Coherence Tomography for Retinal Surgery: Perioperative Analysis to Real-Time Four-Dimensional Image-Guided Surgery
      Magnification of the surgical field using the operating microscope facilitated profound innovations in retinal surgery in the 1970s, such as pars plana vitrectomy. Although surgical instrumentation and illumination techniques are continually developing, the operating microscope for vitreoretinal procedures has remained essentially unchanged and currently limits the surgeon's depth perception and assessment of subtle microanatomy. Optical coherence tomography (OCT) has revolutionized clinical management of retinal pathology, and its introduction into ...
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    11. Optical coherence tomography of the preterm eye: from retinopathy of prematurity to brain development

      Optical coherence tomography of the preterm eye: from retinopathy of prematurity to brain development
      Preterm infants with retinopathy of prematurity are at increased risk of poor neurodevelopmental outcomes. Because the neurosensory retina is an extension of the central nervous system, anatomic abnormalities in the anterior visual pathway often relate to system and central nervous system health. We describe optical coherence tomography as a powerful imaging modality that has recently been adapted to the infant population and provides noninvasive, high-resolution, cross-sectional imaging of the infant ...
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    12. 1-15 of 111 1 2 3 4 5 6 7 8 »
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  2. About Cynthia A. Toth

    Cynthia A. Toth

    Cynthia A. Toth, MD, is a Professor of Ophthalmology Vitreoretinal Diseases and Surgery and Professor of Biomedical Engineering at Duke. 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: 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). Dr. Toth’s primary research interests include improving diagnostic methods and therapy for macular degeneration and the development and application of optical coherence tomography for macular diseases. She has been repeatedly honored among the Best Doctors in America.

  3. Quotes

    1. Now, for the first time, we can take the SD OCT system into the neonatal intensive care unit and hold it over the infant's eye without touching the eye and image the retina while the infant is lying in the bed.
      In Mapping a baby’s retina for signs of blindness
    2. SD OCT reveals the retina in greater detail than was ever before realized, allowing us to observe disease at almost the cellular level
      In New device finds early signs of eye disease in preemies
    3. We can see just amazing things in these young children's eyes that we never suspected.
      In Testing tool to better detect premature baby eye disease
    4. One benefit of SD-OCT is the creation of the summed voxel projection [SVP], which is helpful for orientation of individual OCT scans. One can collapse three-dimensional OCT volumes along the depth axis to form a two-dimensional plane, summing pixels to calculate one representative pixel intensity alone each line in the projection.
      In Spectral-domain optical coherence tomography an improvement over previous optical coherence tomography systems