One Isolated Roth Spot

[KHE]

---

Members don't see this ad.

55 year old healthy woman presents for eye exam. No significant complaints. No significant medical history. No medications.

All ocular examination within normal limits with the exception of one flame shaped retinal heme with a Roth Spot in the center of it temporal to the macula. Blood pressure is 120/80.

Patient reports general physical a few months ago with blood work up was all normal. Blood work consisted of CBC, lipid panel, thyroid functions, the usual suspects.

Patient says she feels great.

How worked up are you going to get over this? What tests, if any do you want to order? Follow the patient up when?

 

[Visionary]

55 year old healthy woman presents for eye exam. No significant complaints. No significant medical history. No medications.

All ocular examination within normal limits with the exception of one flame shaped retinal heme with a Roth Spot in the center of it temporal to the macula. Blood pressure is 120/80.

Patient reports general physical a few months ago with blood work up was all normal. Blood work consisted of CBC, lipid panel, thyroid functions, the usual suspects.

Patient says she feels great.

How worked up are you going to get over this? What tests, if any do you want to order? Follow the patient up when?

Unlikely to be significant. I've seen these isolated hemorrhages from time to time. They typically clear without sequelae. The white center is not pathomnemonic for infection or leukemic infiltration. It's possible to get a similar finding with a mild Valsalva-type picture. The recent nml bloodwork and BP measurement are reassuring. I would see her again in 3 months or earlier, if symptomatic. I suspect the hemorrhage will have cleared by then.

 

[OjoCinco]

I wish the forum could be used for things like this more often. I learn a lot from example cases like this, and the interaction between you all makes it a lot less pedantic.

Are there other forums or listservs that do this?

 

[Visionary]

I wish the forum could be used for things like this more often. I learn a lot from example cases like this, and the interaction between you all makes it a lot less pedantic.

Are there other forums or listservs that do this?

The AAO site now has a message board with a number of groups, covering various topics. You can participate, even as a member in training. You'll find many case discussions. Such discussions tend to be avoided on this site, particularly if initiated by visitors, as it is not supposed to be a forum for medical advice.