Roth's spots, white-centered hemorrhages

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.

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

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).

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

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

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.