Roth's spots

Roth's Spots

Roth's spots are retinal hemorrhages with white or pale centers, which are observed during a fundoscopic examination of the eye. They are named after the Swiss pathologist Moritz Roth, who first described them in 1872. Roth's spots are considered a significant clinical finding and can be indicative of various systemic conditions, most notably infective endocarditis.

Pathophysiology

Roth's spots are thought to result from retinal capillary rupture, leading to hemorrhage. The white center is composed of fibrin, platelets, and sometimes leukocytes. The presence of these spots is often associated with immune complex deposition and vasculitis, which can occur in several systemic diseases.

Causes

Roth's spots can be associated with a variety of conditions, including:

• Infective endocarditis: This is the most classic association, where Roth's spots are considered one of the peripheral stigmata of the disease.
• Leukemia: Particularly acute forms, where there is a high turnover of cells and increased risk of hemorrhage.
• Diabetes mellitus: Due to microvascular complications.
• Hypertension: Chronic high blood pressure can lead to retinal changes.
• Anemia: Severe anemia can lead to retinal hemorrhages.
• HIV/AIDS: Due to associated opportunistic infections and vasculitis.

Clinical Significance

The presence of Roth's spots can aid in the diagnosis of underlying systemic conditions. They are not specific to any one disease but should prompt further investigation into potential causes, especially if found in conjunction with other clinical signs.

Diagnosis

Roth's spots are diagnosed through a comprehensive eye examination using an ophthalmoscope. They appear as round or oval red spots with a white or pale center on the retina. The examination should be performed by a trained ophthalmologist or healthcare professional.

Management

Management of Roth's spots involves addressing the underlying condition. For example, in the case of infective endocarditis, appropriate antibiotic therapy is crucial. In cases related to systemic diseases like diabetes or hypertension, controlling the primary disease can help prevent further retinal damage.

Prognosis

The prognosis of Roth's spots depends on the underlying cause. If the systemic condition is managed effectively, the retinal changes may resolve. However, persistent or recurrent Roth's spots may indicate ongoing systemic issues that require further medical attention.

Also see

• Retinal hemorrhage
• Infective endocarditis
• Fundoscopic examination
• Vasculitis
• Ophthalmology

External

• Age-Related Macular Degeneration

• Amblyopia (Lazy Eye)

• Anophthalmia and Microphthalmia

• Astigmatism

B

• Behçet's Disease* Bietti's Crystalline Dystrophy

• Blepharitis* Blepharospasm

C

• Cataracts

• Coloboma

• Color Blindness

• Corneal Conditions

D

• Diabetic Retinopathy

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F

• Floaters

G

• Glaucoma

I

• Idiopathic Intracranial Hypertension

L

• Low Vision

M

• Macular Edema

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P

• Pink Eye

R

• Rare Diseases

• Refractive Errors

• Retinal Detachment

• Retinitis Pigmentosa

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S

• Stargardt Disease

U

• Usher Syndrome

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V

• Vitreous Detachment