Roth's spots, white-centered hemorrhages

Last updated on: 23.08.2022

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History
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Moritz Roth (1839-1914),. In 1872, the Swiss pathologist Moritz Roth first described retinal red spots as well as white spots in sepsis. The spots with a white center, now called Roth spots, were first described six years later by the biologist M. Litten.

Definition
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Retinal hemorrhages with a characteristic morphology are described as "Roth spots". They typically occur in infective endocarditis (see below Endocarditis lenta).

Pathophysiology
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It is assumed that a rupture of the retinal capillaries with intraretinal hemorrhage leads to activation of the coagulation cascade, so that a local fibrin thrombus develops. All diseases with endothelial dysfunction and increased capillary fragility are possible causes (see classification below).

Clinical picture
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Roth spots are usually asymptomatic and are discovered incidentally during ophthalmologic examination. However, visual disturbances may occur with macular localization of the hemorrhages.

Therapy
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Specific treatment of Roth stains is not necessary. The decisive factor is their identification and the analysis of their causes.

Literature
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  1. Arora N et al (2020) Roth's spots, a clinical diagnostic clue for infective endocarditis. Perm J 24:20,038.
  2. Khawly JA et al (1994) Litten's sign (Roth's spots) in bacterial endocarditis. Arch Ophthalmol 112:683-684.
  3. Litten M. Ueber akute maligne endocarditis und die dabei vorkommenenden retinal veranderungen, Charite-Ann. 1878; 3: 135.

Outgoing links (1)

Endocarditis lenta;

Last updated on: 23.08.2022