[The ground visual field assessment, using two methods, compared with Goldmann perimetry]. / Évaluation du champ visuel au sol, selon deux méthodes, comparée avec le champ visuel de Goldmann. Validation de l'évaluation du champ visuel au sol.

In visual rehabilitation, ground visual field assessment (GVFA) makes it possible to assess the size of scotomas in connection with locomotion and to restore the width of the patient's visual field (VF). The information obtained by these tests has never been compared with Goldmann testing. The purpose of this study was to assess the reproducibility of VF measurement under different conditions (Goldmann perimetry, manual and automated GVFA). Ten patients (51.4±14.0 years, 4 men and 6 women) with tunnel fields inferior or equal to the central 25°, performed three different versions of a binocular VF assessment: Goldmann perimetry, manual GVFA, and automated GVFA. The two versions of the GVFA were performed at 1m then 5m from the patient on the ground, and finally 5m away from the patient at eye level, facing the patient. The main outcome was the total perceived surface for each test. The reproducibility of the measurement was average or good for the test at 1m (ICC=0.685 to 0.866). Conversely, it was very poor between the tests at 5m, except for the automated and manual GVFA at 5m on the ground (ICC=0.888). This study shows good reproducibility of the GVFA measurements at 1m with less reproducibility at 5m, which can be explained by difficulties in the execution of the GVFA. Among the tests, the automated GVFA appears to be more reliable than the manual GVFA and is preferred by patients.

[Epidemiology and prognostic significance of bladder sphincter disorders after an initial cerebral hemisphere vascular accident]. / Epidémiologie et signification pronostique des troubles vésicosphinctériens après un premier accident vasculaire cérébral hémisphérique.

OBJECTIVE: To document incidence of poststroke urinary incontinence and retention and to determine its effect on 3 months outcome. METHODS: Prospective cohort study. One hundred fifty-five cases of first hemispherical stroke were classified by continence status, retention or incontinence, at D2 after stroke. Age, sex, stroke location and aetiology, hypertension, diabetes were noted. Outcome data collected at D15 and D90 included impairments, disabilities, quality of life and case fatality rates. Disabilities were measured with Barthel Index (BI), Franchay Arm Test (FAT), New Functional Ambulation Classification (NFAC) and quality of life with EuroQol. RESULTS: Of the 155 patients, 62 had initial urinary disorders. The incidence was 40% at D2, 32% at D15 and 19% at D90. Retention represented 36% of urinary disorders at D2 and D15 and only 19% at D90. Urinary disorders were associated with motor weakness, lower Barthel Index, dysphasia, aphasia, apraxia and unilateral neglect. There was no relation with sex, age, stroke aetiology and diabetes. At D90, patients with initial urinary disorders had higher case fatality rates 22% versus 16% (P < 0.0001) and greater disabilities: BI of 60 versus 90 (P < 0.0001), NFAC of five versus seven (P < 0.0001), FAT of four versus six (P = 0.0019). CONCLUSION: Poststroke urinary disorders were associated with stroke gravity and adversely affected D90 stroke survival rates and functional outcome. Retention was strongly associated with D90 survival rates.