White-centered, oval hemorrhages, apparently situated in the nerve-fiber layer, constitute the ocular hallmark of subacute bacterial endocarditis. They are frequently and erroneously called Roth spots. Various opinions exist regarding the morphology of these white-centered hemorrhages. In the following case, several such lesions were clinically identified and microscopically studied.
Report of Case
A very ill 57-year-old white woman with a petechial skin eruption was admitted to Bellevue Hospital. On the second hospital day, subacute bacterial endocarditis was diagnosed and antibiotic therapy begun. The patient failed to respond and died the following day. At autopsy, bacterial vegetations were found on the aortic and mitral valves. There were scattered organizing intravascular thrombi in many organs and the brain contained numerous microabscesses.On the second hospital day the fundi of this patient were examined, using an electric ophthalmoscope. The discs were slightly hyperemic but the margins were not blurred. White-centered elliptical hemorrhages were seen