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Roth spots seen on fundoscopic examination (white-centered hemorrhages) were classically described as septic emboli in patients with subacute bacterial endocarditis (SBE). Many physicians have considered them pathognomonic for this entity. More recent evidence suggests, however, that they are nonspecific and may be found in other disease states. A review of the pathogenesis of these white-centered hemorrhages will be provided, along with some diseases other than SBE in which they may occur.