Spectral-domain optical coherence tomography of roth spots.
OBJECTIVE
To describe the retinal findings of subacute bacterial endocarditis, their evolution after treatment, and analysis with spectral-domain optical coherence tomography.


METHODS
Retrospective chart review.


RESULTS
A 21-year-old man presented with the sudden onset of a central scotoma in his left eye because of a sub-internal limiting membrane hemorrhage overlying the left fovea. When examined 2 weeks later, Roth spots were noted in his right eye. The patient was immediately referred to his internist and diagnosed with subacute bacterial endocarditis with cultures positive for Streptococcus viridans. He subsequently underwent aortic valve replacement surgery after 4 weeks of intravenous antibiotic therapy. When examined 4 weeks after valve replacement surgery, there was regression of the Roth spots.


CONCLUSIONS
The present case demonstrates the importance of a funduscopic examination in the early diagnosis and management of subacute bacterial endocarditis. The analysis of Roth spots with spectral-domain optical coherence tomography suggested that they were septic emboli.
*Vitreous, Retina, Macula Consultants of New York and the LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York; and †Department of Ophthalmology, New York University School of Medicine, New York, New York.
Jerome
J
Giovinazzo
Sarah
S
Mrejen
K Bailey
KB
Freund