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Photo Essay
November 2002

Roth Spots

Arch Ophthalmol. 2002;120(11):1596. doi:10.1001/archopht.120.11.1596

A 40-YEAR-OLD MAN was referred to our eye center because of blurry vision in both eyes. His medical history was significant for osteogenic sarcoma originating in the right tibia with known bone, pulmonary, and brain metastases. He had been previously treated with chemotherapy and radiation therapy. He was admitted to the hospital with a hemoglobin level of 2.5 g/dL and transfused with 5 U of packed red blood cells. He experienced sudden onset of blurry vision 1 day after the transfusion. Best-corrected visual acuities were 20/60 OD and 20/70 OS. The results of his ophthalmic examination were normal, except for the dilated fundus examination. Multiple Roth spots, located primarily within the posterior pole, were observed in both eyes (Figure 1). Hemorrhages were present in the macular region and were associated with retinal thickening that was most likely responsible for the decrease in vision. Fluorescein angiography did not reveal any leakage of fluid into the macular region.

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