|Other names: Litten sign|
|Roth spot on the retina of the left eye in infective endocarditis|
|Specialty||Ophthalmology, cardiology, general medicine|
|Symptoms||Red spots with white or pale centres|
|Causes||Conditions that predispose to endothelial damage of retinal capillaries|
|Diagnostic method||Fundoscopy, visual appearance|
|Frequency||80% of people with subacute bacterial endocarditis|
Roth spots, also known as Litten spots are non-specific red spots with white or pale centres, seen on the retina. Although traditionally associated with infective endocarditis, they can occur in a number of other conditions including hypertension, diabetes, collagen vascular disease, extreme hypoxia, leukemia and HIV.
The spots are typically observed via fundoscopy (using an ophthalmoscope to view inside the eye) or slit lamp exam. They can be composed of coagulated fibrin including platelets, focal ischaemia, inflammatory infiltrate, infectious organisms, or neoplastic cells.
Around 80% of people with subacute bacterial endocarditis have Roth spots. Red and white retinal spots were first observed in 1872 by Swiss physician Moritz Roth, and named "Roth spots" six years later by Moritz Litten.
Roth's spots occur in conditions that predispose to endothelial damage of retinal capillaries, that is when there is dysfunction and disruption of the endothelium of retinal capillaries. Looking through the microscope reveals lesions with white centers made mainly of fibrin, depicting a fibrin-platelet plug at the site of vessel damage.
- Infective endocarditis
- Collagen vascular disease
- Hypertensive retinopathy
- Diabetic retinopathy
- Human Immunodeficiency Virus (HIV)
- Extreme hypoxia
- Shaken-baby syndrome
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