Roth spots serve as a clue to underlying acute myeloid leukemia

Acute myeloid leukemia (AML) is one of the causes of Roth spots. Here, we report a female patient in her early 30s of Asian origin presented to our ophthalmology outpatient clinic with chief complaints of decreased visual acuity (VA) in the right eye along with generalized weakness, palpitations, and colored stools. The best corrected VA in the right eye was counting fingers 1 m and 6/6 in the left eye. Fundus examination revealed Roth spots and subhyaloid hemorrhages in the right eye and Roth spots in the left eye. Peripheral smear revealed few blasts, and bone marrow showed 58% blasts, with increased cellularity suggestive of AML. Currently, the patient is on an induction chemotherapy course under oncologist treatment. The presence of Roth spots in the fundus picture may require a complete blood picture examination as they may be present in leukemia also.