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3-04: Roth Spots

David Effron; Beverly C. Forcier; Richard E. Wyszynski

Clinical Summary

Roth spots are retinal hemorrhages with a white or yellow center. They may be seen in patients with a host of diseases such as anemia, leukemia, multiple myeloma, diabetes mellitus, collagen vascular disease, other vascular diseases, intracranial hemorrhage in infants, septic retinitis, and carcinoma. Flame-shaped or splinter hemorrhages or dot-blot hemorrhages may resemble Roth spots.

Management and Disposition

Routine referral for general medical evaluation is appropriate.

Pearls

  1. Roth spots are not pathognomonic for any particular disease process and can represent a variety of clinical conditions.

  2. These lesions represent red blood cells surrounding inflammatory cells.

FIGURE 3.7

Roth Spots. Multiple retinal hemorrhages with pale centers are seen. (Photo contributor: Tal Rubinstein, MD.)

In a patient with Roth spots, there are multiple retinal hemorrhages with pale centers.
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FIGURE 3.8

Roth Spot. Retinal hemorrhage with pale center. (Photo contributor: William E. Cappaert, MD.)

A photo and an illustration depict a Roth Spot or retinal hemorrhage of the eye.
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