J Korean Ophthalmol Soc.  2007 Nov;48(11):1579-1582.

A Case of White-centered Retinal Hemorrhage in Infective Endocarditis

• Jeong HW
• Mun SJ
• Kweon EY
• Lee DW
• Cho NC

Abstract

PURPOSE: To report a case of white-centered retinal hemorrhage in infective endocarditis.
CASE SUMMARY
A 45-year-old patient complained of acute visual loss. The patient had a history of epidural anesthesia for the relief of back pain. On the day of admission the patient showed no light perception and had a white-centered retinal hemorrhage and cotton wool spot in the left eye upon fundus examination. Other ocular manifestations were not specific and there were no specific findings on a brain MRI and visual evoked potential. The patient was diagnosed with pyogenic spondylitis and was treated by abscess drainage and systemic antibiotics therapy. The patient's near vision improved up to 0.4/0.5. He was diagnosed with infective endocarditis based on the echocardiogram with epidural and subarachnoid hemorrhage.
CONCLUSIONS
Roth spot can occur in many diseases such as diabetes, leukemia, anemia, and trauma, but most commonly in sepsis due to infective endocarditis. Therefore, medical evaluation and an echocardiogram for patients with white-centered retinal hemorrhage should be considered.

Keyword

Infective endocarditis; Roth spot; White-centered retinal hemorrhage

MeSH Terms

Abscess
Anemia
Anesthesia, Epidural
Anti-Bacterial Agents
Back Pain
Brain
Drainage
Endocarditis*
Evoked Potentials, Visual
Humans
Leukemia
Magnetic Resonance Imaging
Middle Aged
Retinal Hemorrhage*
Retinaldehyde*
Sepsis
Spondylitis
Subarachnoid Hemorrhage
Wool
Anti-Bacterial Agents
Retinaldehyde

Figure

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  Figure 1. Fundus appearance of the left eye shows white centered retinal hemorrhage (arrow) and cotton wool spot (arrow head).

• 

  Figure 2. Echocardiogram show valvular vegetation.

Reference

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