Roth's spots, also known as Litten spots or the Litten sign,[1] are non-specific red lesions with white or pale centres, seen on the retina of the eye and although traditionally associated with infective endocarditis, can occur in a number of other conditions including hypertension, diabetes, collagen vascular disease, extreme hypoxia, leukemia and HIV.
They are typically observed via fundoscopy (using an ophthalmoscope to view inside the eye) or slit lamp exam.
[2][3] The original retinal spots identified in 1872 were attributed to nerve-fibres that had burst.
Present-day analysis shows that they can be composed of coagulated fibrin including platelets, focal ischaemia, inflammatory infiltrate, infectious organisms, or neoplastic cells.
Looking through the microscope reveals lesions with white centers made mainly of fibrin, depicting a fibrin-platelet plug at the site of vessel damage.