Roth Spot

The Roth Spot is a white-centered hemorrhage. Actually, it is a cotton wool spot surrounded by hemorrhage. The cotton wool comes from ischemic bursting of axons; the small hemorrhage comes from ischemic bursting of a pre-capillary arteriole. Many, many conditions may cause this. It is not, as often supposed, specific to bacterial endocarditis!

Roth's spots are retinal hemorrhages with white or pale centers composed of coagulated fibrin. 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 anaemia, ischemic events, and rarely in HIV retinopathy.