Roth spots serving as a clue to underlying acute myeloid leukemia

Acute myeloid leukemia is one of the causes of Roth spots. We report here a female patient in her early thirties, of Asian origin, presenting to our ophthalmology outpatient clinic with complaints of decreased visual acuity in the Right eye along with generalized weakness, palpitations, and colored stools. The best corrected visual acuity in the Right eye was counting fingers one meter and 6/6 in the left eye. Fundus examination revealed Roth spots and sub-hyaloid 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 Acute myeloid leukemia. The patient is currently 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 Leukaemias also.