Roth spots are retinal hemorrhages with what characteristic?

• A. Pale centers
• B. Red rims
• C. Fluid exudates
• D. Cotton-wool spots

Answer: (A)

Roth spots are retinal hemorrhages that have pale, white centers. The pale center is made up of coagulated fibrin with deposited platelets inside the hemorrhage, giving a distinct pale core within the red dot. This appearance is classically seen in bacterial endocarditis and reflects microvascular injury with a fibrin-platelet thrombus at the site of hemorrhage. Other retinal findings describe different processes: cotton-wool spots are fluffy white ischemic nerve fiber layer lesions, while simple exudates or other color patterns don’t define the Roth spot’s pale center.