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http://www.revoptom.com/content/c/20600/
VOLUME 3, NUMBER 42
August 26, 2013

DURING A RETINAL EXAM, YOU NOTICE A UNIQUE LESION THAT CAN BE DESCRIBED AS A HEMORRHAGE WITH A WHITE CENTER. WHAT IS IT?

Photo credit: Amanda S. Legge, OD. Click here to view larger image.
This finding is a Roth's spot. Its white center represents an accumulation of white blood cells, septic emboli, platelets or even focal ischemia.

Several systemic diseases may yield Roth’s spots. Initially, they were associated with acute bacterial endocarditis. However, we now know that Roth's spots may be linked to a host of other conditions, including leukemia, preeclampsia, Behçet's disease, HIV, diabetes, anemia and hypertensive retinopathy.

If Roth's spots are noted during an examination, refer the patient to his or her primary care doctor for lab work, including a complete blood count with differential, erythrocyte sedimentation rate, venereal disease research laboratory testing, serum and urine protein electrophoresis, and blood cultures. Additionally, the patient may require an echocardiogram to help confirm the underlying cause.
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