Hyperviscosity Syndrome Revealed by White-Centered Retinal Hemorrhages (Roth Spot)

White-centered retinal hemorrhages, also known as Roth spots, have long been considered pathognomonic of infective endocarditis but can be associated with several pathologies. They can be a presentation of a blood hyperviscosity syndrome in the context of multiple myeloma, light chain gammopathy, or cryoglobulinemia through a mechanism of retinal venous stasis, potentially progressing to vein occlusion. We present the case of a 55-year-old woman with no significant medical history who presented a gradual bilateral decline in visual acuity. Fundoscopic examination revealed multiple white-centered hemorrhages, and further investigation promptly linked them to a blood hyperviscosity syndrome.