Discrepancy between Visual Acuity and Microperimetry in AMD Patients: Visual Acuity Appears as an Inadequate Parameter to Test Macular Function.

BACKGROUND: Best corrected visual acuity (BCVA) of 0.8 or above in AMD patients can sometimes correspond to poor macular function inducing a serious visual handicap. Microperimetry can be used to objectivize this difference. PATIENTS AND METHODS: A retrospective study was undertaken on 233 files of AMD patients of whom 82 had had a microperimetry. BCVA was compared with microperimetry performance. All examinations were performed in an identical setting by the same team of 3 persons. RESULTS: Among the 82 patients included, 32 (39.0%) had a BCVA equal to or above 0.8 even though their microperimetry performance was lower than 200/560 db. 10 of them (12.2% of total) had an even poorer microperimetry below 120/560 db indicating poor macular function. CONCLUSIONS: More than a third of the AMD patients had a bad or very bad microperimetry performance in parallel with a good visual acuity. Microperimetry is a valuable tool to assess and follow real macular function in AMD patients when visual acuity alone can be misleading.

[Abdominal pain among elderly patients in the emergency department]. / Abdomen aigu chez la personne âgée aux urgences.

With the population ageing, each physician will increasingly be confronted with older patients, who often suffer from multiple ailments. In such population, abdominal pain, though a frequent complaint, can present a real challenge as history and clinical examination may be misleading. This symptom is however the fourth most frequent ground for consultation in the emergency department and is often a major consumer of time and money. It therefore seems essential to address each case of abdominal pain in the elderly with methodology and bearing in mind at all times that the usual clinical signs may be missing or deceiving. Diagnosis of nonspecific abdominal pain often marks the end of the consultation once the worst has been excluded.