[Perceptions of benign prostatic hyperplasia according to the perspective of patients and general practitioners - the Trophée study]. / Perceptions de l'hypertrophie bénigne de la prostate par le patient et le médecin généraliste - étude Trophée.

OBJECTIVE: To compare the perception of benign prostatic hypertrophy (BPH) between patients and general practitioners (GPs) in terms of severity and evolution of symptoms and medication adherence. METHODOLOGY: A cross-sectional observational study was performed in France in a sample of GPs who included patients for whom a BPH treatment was prescribed. Data were collected on patient and GP characteristics, diagnosis, BPH management, severity and evolution of symptoms and medication adherence. RESULTS: One thousand and ninety-eight patients were recruited by 247 GPs. In 87.4% of cases, diagnosis was performed by GPs. Among them, 82.7% of patients were treated by monotherapy. The choice of a treatment was mainly based on treatment efficacy and the patient's opinion was taken into account by 5% of GPs. The patient's evaluation of symptoms severity was consistent with the GP's in 53.9% of cases. A worsening of symptoms was reported significantly more frequently by patients (18.5%) than by GPs (8.8%). Among 94 patients who reported poor adherence, GPs estimated that the level of medication adherence was good for 72 of these (77%). CONCLUSION: There was discordance between the evaluation made by GPs and by patients on the perception of BPH symptoms and medication adherence. The patient's opinion was rarely taken into account in the therapeutic decision, reflecting a lack of shared medical decision-making, which would be helpful for the physician in order to optimize BPH management.

[Acute sectoral choroidal ischemia: a case report]. / Ischémie choroïdienne aiguë sectorielle: à propos d'un cas.

Sectoral choroidal ischemia is a classic sign of giant cell arteritis, although the latter is more typically associated with anterior ischemic optic neuropathy or central retinal artery occlusion. We report the case of an acute choroidal ischemia in a 68-year-old, one-eyed patient, who presented with deterioration of visual acuity and metamorphopsia in his left eye (his right eye was counting fingers due to high myopia). Fundus examination revealed retinal pigment epithelium (RPE) alterations and slow choroidal perfusion on fluorescein angiography. Macular Optical Coherence Tomography (OCT) showed a total disruption of the photoreceptor layer. Although prompt corticosteroid therapy preserved some vision, secondary macular retinal pigment epithelial changes limited the visual outcome. No other ophthalmological signs were observed in follow-up.