Roth's Spots in Leukemic Retinopathy

To the Editor: Although the term “leukemic infiltrates” accurately describes the pertinent funduscopic findings in retinopathy in leukemia, which are strikingly pictured in the image by Perazella and Magaldi (Oct. 6 issue), 1 the legend fails to indicate that the distinctive hemorrhages with white centers are Roth's spots. Classically, Roth's spots have been linked with subacute bacterial endocarditis, but the association is not exclusive, since they occur in diverse conditions including leukemia and anemia. 2 Similarly, the pathologic basis of the pale white centers can be focal ischemia, inflammatory infiltrate, a colony of infectious organisms, fibrin and platelets, or an accumulation of . . .