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Roth’s spot, also known as retinitis septica, is a lesion that develops in the back of the eye as a result of a number of different conditions. It is most closely linked to infective endocarditis, a disease in which bacteria or other pathogenic organisms infect the valves of the heart. Other conditions associated with the spots include pernicious anemia and leukemia. The lesions themselves are mostly important because they can help lead a physician or other health care provider to the correct diagnosis. They typically are not associated with the development of any pain or vision loss.
The appearance of a Roth’s spot is characterized by a central white spot surrounded by hemorrhage, or bleeding. They are located on the retina of the eye, and can typically be found in the area near the optic disk, which is the region of the retina through which the optic nerve passes as it carries signals between the eye and the brain. In order to look for Roth’s spots, one would have to use a bright light to look through the pupil and into the back of the eye. Often this process is facilitated by giving patients eye drops to dilate their pupils, widening the examiner’s view of the retina.
Development of a Roth’s spot typically occurs due to inflammation of tiny blood vessels located in the back of the eye, a condition generally known as vasculitis. As the blood vessels become inflamed, blood cannot flow through them, and a white discoloration develops. Since blood trying to pass through this region is held up by the blockage in the artery, blood tends to flow around the white lesion.
Finding a Roth’s spot in the eye helps to diagnose infective endocarditis. According to the Duke criteria, which are guidelines commonly used to diagnose endocarditis, a Roth’s spot is one of the minor criteria needed to make the diagnosis. It, along with other findings including glomerulonephritis and Janeway lesions, are considered the immunologic phenomena. Doctors or other health care providers are able to diagnose endocarditis if there are five minor criteria present, or if there is one major criterion and three minor criteria.
Although a Roth’s spot is most commonly associated with infective endocarditis, a number of other conditions can also cause these lesions to develop. Pernicious anemia, an autoimmune condition in which destruction of parts of the stomach causes malabsorption of vitamin B12, leading to anemia. A number of different types of leukemia, a cancer of the body’s white blood cells, can also be associated with these lesions.