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, provides expertise in advanced image processing for SDOCT in the DARSI Laboratory. In collaboration with Joseph Izatt, PhD 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.
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.
Education and Training
- Drexel University, M.D. 1983
- Geisinger Medical Center, Ophthalmology
- University of California, Davis, School of Medicine, Ophthalmology
Selected Grants and Awards
- Unified Program for Therapeutics in Children
- Intraoperative OCT Guidance of Intraocular Surgery
- Duke CTSA (TL1)
- Retinal Neurovascular Patterning in Preterm Infants
- Highspeed, motion-stabilized, handheld OCTA for pediatric imaging
- Visualizing Retinal Vascular Development and Pathology in Infants
- Bedside Optical Retinal Assessment of Hypoxic Ischemic Encephalopathy in Infants
- Analyzing retinal microanatomy in retinopathy of prematurity to improve care
- Handheld Portable Adaptive Optics Optical Coherence Tomography for Imaging Young Children
- UPENN - Additional Analysis of Data from the Comparison of Age-related Macular Degeneration Treatments Trials CATT and CATT Follow-up Study (CATT FS)
- BIMD - Collaborate Research Agreement
- Handheld Portable Adaptive Optics Scanning Laser Ophthalmoscope for Imaging Young Children
- AREDS2 10-Year Follow-on
- Retinal Imaging with Optical Coherence Tomography in Neonatal Brain Injury to Evaluate and Improve Visual and Neurologic Outcomes
- Evaluating a non-contact fundus camera for retinopathy of prematurity screening
- Intraoperative OCT Guidance of Intraocular Surgery
- UPenn - NEI Follow-up Study: Comparison of AMD Treatment Trials (CATT) YR3
- Gertrude B. Elion Mentored Medical Research Award
- Using Optical Coherence Tomography to Elucidate Optic Nerve Development in Healthy Infants and Children
- RRF Merit Award
- Imaging to predict refractive outcomes after corneal endothelial keratoplasty
- Coordinating Center for the Comparison of AMD Treatments Trials
- Portable Motion Compensated SDOCT System for Imaging Young Children
- Comparison of AMD Treatment Trials-OCT Reading Center
- Real Time Intraoperative SDOCT for Vitreoretinal Surgery
- CATT OCT Reading Center
- Subretinal Transplantation Of Islets Of Langerhans
- Pathogenesis Of Retinal Ischemic Injury