Roth's spots are retinal hemorrhages with white or pale centers. The original retinal spots identified in 1872 were attributed to nerve-fibres that had burst or exploded. Present-day analysis shows that they can be composed of coagulated fibrin including platelets, focal ischemia, inflammatory infiltrate, infectious organisms, or neoplastic cells.  They are typically observed via fundoscopy (using an ophthalmoscope to view inside the eye) or slit lamp exam.
They are usually caused by immune complex mediated vasculitis often resulting from bacterial endocarditis. Roth's spots may be observed in leukemia, diabetes, subacute bacterial endocarditis, pernicious anemia, ischemic events, hypertensive retinopathy and rarely in HIV retinopathy.
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