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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11363
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Roth spots

Customer Question

roth spots
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. Rick replied 5 years ago.
Hi. I'm online and happy to answer your question today.
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 5 years ago.
I didn't see your answer...
Expert:  Dr. Rick replied 5 years ago.
As you probably already know a roth spot is a distinct area of retinal hemorrhage that has a white center. There are many things that can cause the white center. It can be from a collection of white blood cells, fibrin (clot material), Platelets or it can just be an artifact from how the light is being reflected off your retina in the area of the retinal bleeding.
While it is true that roth spots can be seen in leukemia and diabetes (as you have already stated) they are also present in a number of other disease processes such as pernicious anemia, sickle cell disease, scurvy (very rare on a normal diet), and collagen vascular diseases such as systemic lupus.
Sorry about the delay.....My fingers don't type very fast at this time of night :)
I'm still here if you would like to talk more.....let me know
Since you do not have any findings to suggest leukemia or diabetes I would look for one other condition where I have seen roth spots in my practice: subacute bacterial endocarditis causing focal septic chorioretinitis secondary to emboli. I would recommend a echo cardiogram and, possibly, a consultation with a cardiologist.
Yes. It is possible to have a roth spot with nothing serious being wrong. That being said it is important to rule out diseases known to be associated with this retinal finding before reaching that conclusion.
One other thing to keep in mind is the expertise of the doctor who diagnosed you with a roth spot. Make sure she is an ophthalmologist or a retina specialist as less trained individuals may mistake other retinal findings for a roth spots.
Does this make sense to you?
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Are there any other concerns or issues you would like addressed on this topic?
Expert:  Dr. Rick replied 5 years ago.
I'm still here. Do you have any other questions for me?
Customer: replied 5 years ago.

I just had a echo 3 weeks ago..because of history of high blood pressure, which I take medication for.

I am so.o.o confused..Oct blood results were all absolutely normal..I do feel dizzy after eating surgars..but my hgb a1c is normal and blood glucose..sorry just confused by this dx. I guess a second opinion might be in order...other that a Wahlmart doctor..Although very nice.

Expert:  Dr. Rick replied 5 years ago.
If the doctor who told you that you have a roth spot was an optometrist at walmart I would have your eyes examined by an ophthalmologist. In my opinion an optometrist doesn't have enough training to distinguish a roth spot from a benign area of small retinal hemorrhage.
If your echo is normal, and your other labs are normal, I wouldn't worry at this point. I suggest that you follow up with an Eye MD in the near future for a complete exam.
Roth spots fade with time so, if you are not getting more of them, the one that the optometrist said he found may be gone by the time a more knowledgeable physician has a look at you.
I think you will be ok from what you have told me.
Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 5 years ago.
Let me know if there is anything else I can do for you in the future.
If you have a chance drop me a note and let me know if an ophthalmologist believes you have roth spots as the optometrist said.
Take care and have a good night.