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Cynthia Ann Toth

Joseph A.C. Wadsworth Distinguished Professor of Ophthalmology
Ophthalmology, Vitreoretinal Diseases & Surgery
Duke Eye Center, DUMC 3802, Durham, NC 27710
Duke Eye Center, Hudson Bldg., 2351 Erwin Road, Durham, NC 27705

Scholarly Works - Book sections


Imaging in Pediatric Eyes

Book section · January 1, 2023 Multimodal imaging in pediatric eyes is useful for the diagnosis, treatment, and monitoring of several disease processes. Imaging in pediatric patients can be challenging to perform in clinic and an exam under anesthesia (EUA) may be required. Coordination ... Full text Cite

Proliferative Vitreoretinopathy

Book section · January 1, 2022 Proliferative vitreoretinopathy (PVR) is a clinical syndrome associated with proliferation of cells in the vitreous cavity and on the retinal surface leading to tractional forces on the retina. PVR is the most common cause of re-detachment after retinal de ... Full text Cite

Intraoperative OCT imaging

Book section · January 1, 2022 The application of optical coherence tomography (OCT) to the operating room has experienced significant advances over the last few years. The early development of portable OCT systems represented a major shift forward in the ability to provide image-guided ... Full text Cite

Foveal Development in Retinopathy of Prematurity

Book section · January 1, 2021 Human foveal development is a complex process that can be altered by retinopathy of prematurity (ROP). Establishing a baseline of normal foveal development is paramount before understanding the impact caused by prematurity and ROP. It is important to recog ... Full text Cite

OCT and OCTA image capture in the nursery, clinic, and operating room

Book section · January 1, 2019 Different scan protocols are useful when performing optical coherence tomography (OCT) on a cooperative patient who is able to fixate versus on an infant or young child. Although there are overlaps in scan acquisition patterns across different commercial s ... Full text Cite

Introduction to age-dependent features in pediatric OCT imaging

Book section · January 1, 2019 An overview of age-dependent features is presented. ... Full text Cite

Incontinentia pigmenti

Book section · January 1, 2019 Incontinentia pigmenti (IKBKG/NEMO gene-related retinopathy, Bloch-Sulzberger syndrome) is an X-linked dominant disorder characterized by abnormalities of the skin, teeth, nails, hair, retina, and central nervous system (CNS) and usually lethal before birt ... Full text Cite

Coats disease and coats plus syndrome

Book section · January 1, 2019 Coats disease, or Leber multiple miliary aneurysm disease, is characterized by idiopathic retinal vascular telangiectasias that can occur with retinal exudates and exudative retinal detachments. In this chapter, we discuss the clinical features, optical co ... Full text Cite

Inflammatory and idiopathic choroidal neovascularization

Book section · January 1, 2019 This chapter reviews the imaging findings for diagnosis and monitoring treatment response of inflammatory pediatric choroidal neovascular membranes. ... Full text Cite

Familial exudative vitreoretinopathy and norrie disease

Book section · January 1, 2019 Familial exudative vitreoretinopathy (FEVR), Norrie disease, and other retinal diseases with a FEVR-like appearance are diseases of abnormal vascular development with peripheral retinal vascular nonperfusion as a predominant feature. Optical coherence tomo ... Full text Cite

Retinopathy of prematurity

Book section · January 1, 2019 Retinopathy of prematurity (ROP) is identified clinically by a pattern of incomplete and abnormal retinal vessel development in preterm infants. Assessment is centered on determining whether retinal findings indicate a course of disease that requires treat ... Full text Cite

Optical coherence tomography and wide-field fluorescein angiography in retinopathy of prematurity

Book section · April 6, 2017 The advent and adaptation of many imaging modalities promise to revolutionize our understanding of retinopathy of prematurity (ROP) by improving the detection, diagnosis, and monitoring of response to treatment of this disease. Diagnosis and classification ... Full text Cite

New applications of super-resolution in medical imaging

Book section · January 1, 2017 The image processing algorithms collectively known as super-resolution have proven effective in producing high-quality imagery from a collection of low-resolution photographic images. In this chapter, we examine some of the advantages and challenges of app ... Full text Cite

Intraoperative retinal optical coherence tomography

Book section · January 1, 2015 In this chapter, the emerging applications for OCT in real-time, intraoperative diagnostic imaging and visualization of surgical maneuvers is reviewed, focusing on OCT guidance and evaluation of ophthalmic microsurgery. Three different approaches under dev ... Full text Cite

Macular translocation

Book section · January 1, 2012 Full text Cite

Visualization of vitreoretinal surgical manipulations using intraoperative spectral domain optical coherence tomography

Book section · April 12, 2011 Vitreoretinal surgical visualization by ophthalmic microscopy is limited in its ability to distinguish thin translucent tissues from other retinal substructures. Conventional methods for supplementing poor contrast, such as with increased illumination and ... Full text Cite

Segmentation of ophthalmic Optical Coherence Tomography images using graph cuts

Book section · December 1, 2010 We describe an efficient approach for the automated segmentation of pathological/morphological structures in ophthalmic Spectral Domain Optical Coherence Tomography (SDOCT) images. In this algorithm, image pixels are treated as nodes of a graph with edge w ... Full text Cite

Retinopathy of prematurity

Book section · December 1, 2010 Full text Cite

Real-time intraoperative spectral domain optical coherence tomography for vitreoretinal surgery

Book section · May 3, 2010 Vitreoretinal surgery visualization is inherently limited by the ability to distinguish between tissues with subtle contrast, and to judge the location of an object relative to other retinal substructures. Inherent issues in visualizing thin translucent ti ... Full text Cite

Retinopathy of prematurity

Book section · March 3, 2010 Full text Cite

Applications of spectral-domain OCT in AMD

Book section · December 1, 2009 High-resolution optical imaging of objects hidden in scattering media such as the human eye is a challenging and important problem with many industrial and medical applications. © 2009 Springer Berlin Heidelberg. ... Full text Cite

Efficient restoration and enhancement of super-resolved X-ray images

Book section · December 1, 2008 Our previous work demonstrates the ability to reconstruct a single higher resolution image from fusing a collection of multiple extremely low-dosage aliased X-ray images. While this computationally efficient method eliminates aliasing artifacts associated ... Full text Cite

Fast detection and segmentation of drusen in retinal optical coherence tomography images

Book section · May 26, 2008 Accurate detection-characterization of drusen is an important imaging biomarker of age-related macular degeneration (AMD) progression. We report on the development of an automatic method for detection and segmentation of drusen in retinal images captured v ... Full text Cite

Development of quantitative diagnostic observables for age-related macular degeneration using Spectral Domain OCT

Book section · August 31, 2007 We report on the development of quantitative, reproducible diagnostic observables for age-related macular degeneration (AMD) based on high speed spectral domain optical coherence tomography (SDOCT). 3D SDOCT volumetric data sets (512 × 1000 × 100 voxels) w ... Full text Cite

Precision targeting with a tracking adaptive optics scanning laser ophthalmoscope

Book section · June 30, 2006 Precise targeting of retinal structures including retinal pigment epithelial cells, feeder vessels, ganglion cells, photoreceptors, and other cells important for light transduction may enable earlier disease intervention with laser therapies and advanced m ... Full text Cite

Mechanical characterization of the vitreous body with acoustic radiation force

Book section · December 1, 2004 As we age, substantial mechanical and structural alterations occur in the vitreous. These changes are believed to induce a series of vision threatening conditions, including retinal detachment and nuclear sclerotic cataracts. We have developed an acoustic ... Cite

A comparative study of ocular damage thresholds from continuous-wave and femtosecond mode-locked lasers

Book section · January 1, 2001 In order to provide a direct comparison of the damage thresholds for mode-locked systems to those with continuous-wave (CW) or non-pulsed output, we have performed an experiment with lasers possessing otherwise identical output characteristics. Our work pr ... Full text Cite

Retinal damage thresholds for 40 femtosecond laser pulses

Book section · January 1, 2001 We have shown in previous work that the threshold for laser-induced breakdown is higher than the threshold for ophthalmoscopically visible retinal damage, but they approach each other as pulse duration decreased from several nanoseconds to 100 femtoseconds ... Full text Cite

Using optical coherence tomography to elucidate the impact of fixation on retinal laser pathology

Book section · January 1, 2001 Purpose: The direct comparison of in-vivo OCT images with fixed tissue sections assumes the fixation of tissue has no effect on the size and configuration of final pathology images such as light micrographs. Fixation artifact has been a concern in numerous ... Full text Cite

Retinal damage from femtosecond to nanosecond laser exposure

Book section · January 1, 2000 The Air Force has led a research effort to investigate the thresholds and mechanisms for retinal damage from ultrashort laser pulses [i.e. nanosecond (10-9 sec) to femtosecond (10-15 sec) pulse widths]. The results suggest that nonlin ... Full text Cite

Imaging the stiffness of the vitreous body with acoustic radiation force

Book section · December 1, 1999 A new method of vitreous imaging which attempts to image tissue stiffness by applying acoustic radiation force is presented. The method yields the dynamic response of targets to the applied forces. For demonstration purposes, the B-Mode, maximum displaceme ... Cite

Histopathology of ultrashort pulsed laser retinal damage: Changing retinal pathology with variation in spot-size for near-infrared laser lesions

Book section · January 1, 1999 Purpose: We wish to identify the change in extent of retinal tissue injury due to varying the spot size at the retina of ultrashort laser pulses. Methods: We compared the effects of delivery of near infrared (1060 nm) single laser pulses to an 800 micron d ... Full text Cite

Methods of achieving three dimensional reconstruction of tissue at the ultrastructural level demonstrating the distribution of melanosomes within retinal pigment epithelium

Book section · January 1, 1999 In predicting and measuring laser effect on retinal tissue for most of the visible to near infrared spectrum, one is concerned with the melanosome as the major absorber of incident energy. Differences in the location and density of melanosomes in the retin ... Full text Cite

Retinal damage mechanisms and safety for ultrashort laser exposure

Book section · January 1, 1999 For the past several years the US Air Force has led a research effort to investigate the thresholds and mechanisms for retinal damage from ultrashort laser pulses [i.e. nanosecond (10-9 sec) to femtosecond (10-15 sec) pulse widths]. T ... Full text Cite

Multiple pulse thresholds in live eyes for ultrashort laser pulses in the near-infrared

Book section · January 1, 1999 Damage thresholds using multiple laser pulses to produce minimum visible lesions (MVL) in rhesus monkey eyes are reported for near-infrared (800 nm) at 130 femtoseconds. Previous studies by our research group using single pulses in the near-infrared (1060 ... Full text Cite

Comparison of retinal damage thresholds of laser pulses in the macula/paramacula regions of the live eye

Book section · January 1, 1999 Single pulses in the near-infrared (800 nanometers) were used to measure retinal minimum visible lesion (MVL) thresholds in rhesus monkey eyes at a pulse width of 130 femtoseconds (fs) within both the macula and paramacula regions. We report the MVL thresh ... Full text Cite

In-vivo tissue response to free electron laser

Book section · January 1, 1999 Purpose: We analyzed the effect of energy and rate of cutting on the in vivo ocular response to 2.94 μm wavelength Free Electron Laser (FEL) incision of the cornea. We were interested in the difference between our clinical observations of the initial laser ... Full text Cite

Windows of opportunity: Applying ultrashort laser pulses for selective tissue effects

Book section · December 1, 1998 Ultrashort pulsed laser retinal effects vary widely depending on the configuration of the laser energy as it reaches the retina and surrounding structures. Tissue response is determined by: wavelength, pulsewidth, energy per pulse, peak irradiance, linear ... Full text Cite

Visible lesion threshold dependency on retinal spot size for ultrashort laser pulses in the near infrared

Book section · December 1, 1998 Single pulses in the near-infrared (1060 nanometers) were used to measure retinal spot size dependence of minimum visible lesion (MVL) thresholds in rhesus monkey eyes at a pulsewidth of 150 femtoseconds. We report the MVL thresholds determined at 1 hour a ... Full text Cite

Retinal damage mechanisms from ultrashort laser exposure

Book section · December 1, 1998 Extensive research of ultrashort ocular damage mechanisms has shown that less energy is required for retinal damage for pulses shorter than one nanosecond. Laser minimum visible lesion (MVL) thresholds for retinal damage from ultrashort (i.e. < 1 ns) laser ... Full text Cite

Damage mechanisms of pico- and femtosecond laser retinal lesions as viewed by electron microscopy

Book section · December 1, 1998 Retinal lesions produced by ultrashort laser pulses in the pico- and femtosecond range were examined by electron microscopy. Retinal pigment epithelial (RPE) cells that contained fractured and striated melanosomes typically exhibited severe damage to the o ... Full text Cite

Visible lesion thresholds from near-infrared pico- and nanosecond laser pulses in the primate eye

Book section · December 1, 1997 Minimum visible lesions (MVL) are reported for picosecond and nanosecond laser pulses at near-IR wavelengths in the primate eye, Macaca Mulatta. The 50 percent probability for damage (ED50) dosages are reported for the 24 hour for both MVL and f ... Cite

Optical coherence tomography of the retinal response to ultrashort laser pulses

Book section · December 1, 1997 Purpose: to assess the early in vivo evolution of tissue response and wound healing from ultrashort pulsed laser retinal lesions by correlating the cross sectional morphology from sequential optical coherence tomography with histopathologic sectioning. Met ... Cite

Ultrashort laser pulse retinal damage

Book section · December 1, 1997 Recent studies of retinal damage due to ultrashort laser pulses have shown that less energy is required for retinal damage for pulses shorter than one nanosecond. Laser minimum visible lesion (MVL) thresholds for retinal damage from ultrashort (i.e. < 1 ns ... Full text Cite

Histopathology of ultrashort-laser-pulse retinal damage

Book section · January 1, 1996 Recent studies of retinal damage due to ultrashort laser pulses have shown interesting behavior. Laser induced retinal damage for ultrashort (i.e. less than 1 ns) laser pulses is produced at lower energies than in the nanosecond to microsecond laser pulse ... Full text Cite

Perfluorocarbon compounds: transmitting liquids for infrared laser tissue ablation

Book section · January 1, 1996 One concern during IR-laser ablation of tissue under water is the mechanical injury that may be induced in tissue due to rapid bubble expansion and collapse or due to strong laser-induced pressure waves. The objective of this study was to evaluate the feas ... Full text Cite