Integration of ecological indicators to assess a multitemporal impact of cement industries.

The present study evaluated an integrated biomonitoring approach based on three different bioindicators: tree rings, lichens, and beetles in a complex environment (urban-industrial-forest). In Central Italy, four sampling sites were selected to assess the anthropogenic impact of cement plants taking into account (1) long-term exposure (1988-2020) through the analysis of trace elements in tree rings of Quercus pubescens; (2) medium-term exposure (2020-2021) through the analysis of trace elements in thalli (outermost portions) of the lichen Xanthoria parietina; (3) short-term exposure in spring 2021 through the bioaccumulation and evaluation of sample vitality in transplants of the lichen Evernia prunastri and a periodic survey of entomological biodiversity carried out during spring and summer 2021. Trace elements of industrial origin were found in tree rings, with different levels of accumulation between 1988 and 2020 and a maximum in 2012. Native thalli of the lichen X. parietina showed an overall low bioaccumulation of trace elements except for Cr, probably reflecting the influence of national lockdown measures. The transplants of E. prunastri showed a weak stress response in the industrial and urban sites, but not in the forest, and identified Tl and V as the main elements contributing to atmospheric contamination, with peaks at the industrial sites. Concerning the beetles, a significantly lower number of species was found at the Semonte industrial site.

Assessment of cardiopulmonary capacity in deconditioned athletes because of knee injury.

BACKGROUND: An athlete's career inevitably goes through periods of forced physical exercise interruption like a knee injury. Advanced echocardiographic methods and cardiopulmonary exercise testing (CPET) are essential in evaluating athletes in the period elapsing after the injury. However, the feasibility of a maximal pre-surgery CPET and the capacity of resting advanced echocardiographic techniques to predict cardiorespiratory capacity still need to be clarified. METHODS: We evaluated 28 non-professional athletes aged 18-52, involved in prevalently aerobic or alternate aerobic/anaerobic sports activities, affected by a knee pathology with indications for surgical treatment. The evaluation was performed at rest by trans-thoracic echocardiography, including global longitudinal strain (GLS) and myocardial work (MW) assessment, and during exercise by CPET. RESULTS: The percent-predicted peak oxygen consumption (peak VO2%) was 82.8±13.7%, the mean respiratory exchange ratio was 1.16±0.08, and the mean ventilation/carbon dioxide (VE/VCO2) slope was 24.23±3.36. Peak VO2% negatively correlated with GLS (r=-0.518, P=0.003) and global wasted work (GWW) (r =-0.441, P=0.015) and positively correlated with global work efficiency (GWE) (r=0.455, P=0.012). Finally, we found that the VE/VCO2 slope during exercise was negatively correlated with GWE (r=-0.585, P=0.001) and positively correlated with GWW (r=0.499, P=0.005). CONCLUSIONS: A maximal CPET can be obtained in deconditioned athletes because of a knee injury, allowing a comprehensive functional pre-surgery evaluation. In these patients, peak VO2 is reduced due to decreased physical activity after injury; however, a lower cardiopulmonary efficiency may be a concause of the injury itself. In addition, we demonstrated that the MW indexes obtained at rest could predict exercise capacity and ventilatory efficiency as evaluated by CPET.

Accuracy of two-dimensional digital planning in uncemented primary hip arthroplasty: monocentric analysis of eight hundred implants.

PURPOSE: In the last decades, there has been a refinement in total hip arthroplasty, which allowed surgeons to achieve the highest performance and better patient outcomes. Preoperative planning in primary hip arthroplasty is an essential step that guides the surgeon in restoring the anatomy and biomechanics of the joint. This study aims to evaluate the accuracy of the 2D digital planning, considering cup sizing, stem sizing, and limb length discrepancy. Additionally, we conducted a multivariable analysis of demographic data and comorbidities to find factors influencing preoperative planning. METHODS: This retrospective study analyzed the planning accuracy in 800 consecutive uncemented primary total hip arthroplasty. We compared the preoperatively planned total hip arthroplasty with postoperative results regarding the planned component size, the implanted size, and the lower limb length restoration. Therefore, we investigated factors influencing planning accuracy: overweight and obesity, sex, age, past medical history, comorbidities, and implant design. All the surgeries were performed in the posterolateral approach by one expert surgeon who did the preoperative planning. The preoperative planning was determined to be (a) exact if the planned and the implanted components were the same size and (b) accurate if exact ± one size. The restoration of postoperative limb length discrepancy was classified into three groups: ± 3 mm, ± 5 mm, and ± 10 mm. This assessment was performed through a digital method 2D based on a standard hip X-ray. RESULTS: This court of 800 implants showed that planning was exact in 60% of the cups and 44% of the stems and was accurate in 94% of the cups and 80% of the stems. The postoperative limb length discrepancy was ± 3 mm in 91% and ± 5 mm in 97%. CONCLUSIONS: This study showed preoperative 2D digital planning great precision and reliability, and we demonstrated that it was accurate in 94% of the cups and 80% of the stems. Therefore, the preoperative limb length discrepancy analysis was essential to guarantee the recovery of the operated limb's correct length.

LAT1 (SLC7A5) catalyzes copper(histidinate) transport switching from antiport to uniport mechanism.

LAT1 (SLC7A5) is one of the most studied membrane transporters due to its relevance to physiology in supplying essential amino acids to brain and fetus, and to pathology being linked to nervous or embryo alterations; moreover, LAT1 over-expression is always associated with cancer development. Thus, LAT1 is exploited as a pro-drug vehicle and as a target for anti-cancer therapy. We here report the identification of a new substrate with pathophysiological implications, i.e., Cu-histidinate, and an unconventional uniport mechanism exploited for the Cu-histidinate transport. Crystals of the monomeric species Cu(His)2 were obtained in our experimental conditions and the actual transport of the complex was evaluated by a combined strategy of bioinformatics, site-directed mutagenesis, radiolabeled transport, and mass spectrometry analysis. The LAT1-mediated transport of Cu(His)2 may have profound implications for both the treatment of copper dysmetabolism diseases, such as the rare Menkes disease, and of cancer as an alternative to platinum-based therapies.

MicroRNA expression changes in the development of rotator cuff tendon injuries.

Traumatic or degenerative rotator cuff (RC) tendon injuries are a leading cause of persistent shoulder pain and reduction of mobility with associated disability and dysfunction, which require each year more than 250,000 surgical repairs in the United States. MicroRNAs (miRNAs) are small noncoding RNAs, that in the posttranscriptional phase lead to the development and function of tissues. The aim of this review was to identify miRNA expression changes in patients with RC pathologies and to determine their relevance as a potential novel diagnostic and potentially therapeutic tool for RC disorders. Various miRNAs seemed to be key regulators in the muscle architecture, determining several modifications in muscle atrophy, skeletal muscle mechanical adaptation, lipid accumulation, and fibrosis in the presence of RC tears. The search was executed using PubMed, Medline, Scopus, and Cochrane Central. We included studies written in English that evaluated the role of miRNA in diagnosis, physiopathology, and potential therapeutic application of RC tendon injuries. We included 11 studies in this review. Many miRNAs emerged as key regulators in the pathogenesis of RC tears, inflammation, and muscle fatty degeneration. In fact, they are involved in the regulation of myogenesis, inflammatory cytokines, metalloproteases expression, muscle adaptation, adipogenesis, fibrogenic factors, and extracellular matrix synthesis. The gene expression may be altered in the pathological processes of tendon lesions. Therefore, the knowledge of all the gene mechanisms underlying RC tendinopathy should be achieved with future diagnostic and clinical studies.

Ambient and substrate energy influence decomposer diversity differentially across trophic levels.

The species-energy hypothesis predicts increasing biodiversity with increasing energy in ecosystems. Proxies for energy availability are often grouped into ambient energy (i.e., solar radiation) and substrate energy (i.e., non-structural carbohydrates or nutritional content). The relative importance of substrate energy is thought to decrease with increasing trophic level from primary consumers to predators, with reciprocal effects of ambient energy. Yet, empirical tests are lacking. We compiled data on 332,557 deadwood-inhabiting beetles of 901 species reared from wood of 49 tree species across Europe. Using host-phylogeny-controlled models, we show that the relative importance of substrate energy versus ambient energy decreases with increasing trophic levels: the diversity of zoophagous and mycetophagous beetles was determined by ambient energy, while non-structural carbohydrate content in woody tissues determined that of xylophagous beetles. Our study thus overall supports the species-energy hypothesis and specifies that the relative importance of ambient temperature increases with increasing trophic level with opposite effects for substrate energy.

A multicentric evaluation of pediatric lung transplantation in Italy.

BACKGROUND: Pediatric lung transplantation is performed in highly experienced centers due to the peculiar population characteristics. The literature is limited and not representative of individual countries' differences. The purpose of this study was to analyze the Italian experience. METHODS: A multicentric retrospective analysis was performed on 110 pediatric patients (<18 years old) who underwent lung transplantation from 1992 to 2019 at 9 Italian centers. Heart-lung transplantations and lung retransplantations were excluded. RESULTS: The population was composed of 44 male and 66 female patients, with a median age of 15 years. The most frequent indication was cystic fibrosis (83%). One quarter of patients were transplanted in an emergency setting. Median donors' Oto score and age were 1 and 15 years, respectively, with 43% of adult donors. In 17% of patients a graft reduction was performed. Postoperatively, the median duration of mechanical ventilation, intensive care unit, and in-hospital stay were 48 hours, 11 and 35 days, respectively. Thirty-day mortality was 6%, and 1-, 5-, and 10-year survival was 72%, 52%, and 33%, respectively. Risk factors for mortality were Oto score and recipients' body mass index. CONCLUSIONS: The outcomes of pediatric lung transplantation in Italy are comparable with current literature. Particular attention should be paid to the Oto score and recipient body mass index. Conversely, adult donors and graft reductions can be safely used to expand the donor pool.

Early return to activity of daily living after total hip arthroplasty: a systematic review and meta-analysis.

BACKGROUND: Total hip arthroplasty (THA) is an orthopaedic procedure that improves the quality of life in patients suffering from hip pain related to osteoarthritis, fractures, and avascular osteonecrosis of the femoral head. Different surgical approaches can be used for THA leading to different recovery times. Because of the lowering medium age of people undergoing THA, it is important to focus on the earlier return of physiological activity after surgery. AIM: To evaluate the best approach for THA in terms of earlier return to activity. METHOD: Studies comparing the postoperative outcomes in patients who underwent THA through different approaches were analysed focusing on patients' self-reported outcomes, ADL score and UCLA activity score with a short follow-up. RESULTS: A total of 1990 articles were identified in the search, and 14 met the inclusion criteria. The Review Manager software version 5.4 was used to conduct a meta-analysis to compare the direct anterior (DAA) and posterior (PA) approaches, which are the most adopted approaches. An earlier return to walk without aids and to independent ADLs were reported with DAA, but without statistical significance (respectively p = 0.06 and p = 0.10). The time to return to drive was similar among the 2 groups (p = 0.88). The return to work was faster with PA, but no statistical significance was reported (p = 0.47). CONCLUSIONS: Further studies are needed with a larger number of patients, that present homogeneous outcomes, follow-ups and rehabilitation programmes, and that compare similar surgical approaches to assess the early return to activity of daily living after THA.

Modular versus monoblock stem in revision total hip arthroplasty: a systematic review and meta-analysis.

Background: Total hip arthroplasty (THA) is estimated to grow in the following decades with a consequent increase of THA revisions (rTHA). This systematic review and meta-analysis aims to compare modular and monoblock stem in rTHA surgery, focusing on clinical and radiological outcomes and complication rates. Methods: A literature search was performed using the following search strategy: ((Modular stem) OR (monolithic stem)) AND (hip review) on PubMed, Scopus, and Cochrane. Randomized controlled trials (RCTs) and observational studies (OS) compared clinical and radiological outcomes, and complication rates for monoblock and modular revision femoral stem were included. The risk of bias was assessed through the Methodological Index for Non-Randomized Studies (MINORS) score. The Review Manager (RevMan) software was used for the meta-analysis. The rate of complications was assessed using odds ratio (OR) with 95% confidence intervals (CIs). Results: The authors included 11 OS and one RCT with 3,671 participants (mean age: 68.4 years old). The mean follow-up was 46.9 months. There was no prevalence of subsidence for one type of stem. Mean subsidence was from 0.92 to 10 mm for modular stem and from 1 to 15 mm for monoblock stem. Postoperative Harris Hip Score (HHS) showed better results with modular stems without statistical significance [mean difference (MD) =1.32; 95% CI: -1.62 to 4.27; P=0.38]. No statistically significant difference was found for dislocations (OR =2.48; 95% CI: 0.67 to 9.14; P=0.17), infections (OR =1.07; 95% CI: 0.51 to 2.23; P=0.86), intraoperative fractures (OR =1.62; 95% CI: 0.42 to 6.21; P=0.48), and postoperative fractures (OR =1.60; 95% CI: 0.55 to 4.64; P=0.39). Conclusions: Modular and monoblock stems show comparable and satisfactory clinical and radiological outcomes for rTHA. Both stems are valid and effective options for managing femoral bone deficit in hip revision surgery. The main limitation of this study is the small number and low quality of enclosed studies that compared the two stems. Moreover, the modular stem is usually used for more complex cases with lower quality femoral bone stock.

An open and georeferenced dataset of forest structural attributes and microhabitats in central and southern Apennines (Italy).

Forests cover 30% of the Earth's landmass, host 80% of the biodiversity on land, and represent one of the main sinks of carbon. Studying forest ecosystems and dynamics is more crucial than ever now that the climate is changing. On the other hand, forest structural attributes and microhabitats data acquisition is challenging, and require huge efforts. Here we provide a georeferenced dataset of living trees, deadwood, and microhabitats referring to 199 plots (13 m radius), collected between 2012 and 2018, and located over six Apennine mountainous forest types across Italy. The dataset we provide promotes collaboration among researchers and improves the possibilities to analyze the evolution of forest ecosystems.

Open datasets wanted for tracking the insect decline: let's start from saproxylic beetles.

BACKGROUND: We present six datasets of saproxylic beetles collected between 2012 and 2018 in Central and Southern Italian forests. Saproxylics represent one of the main components in forest ecosystems in terms of diversity, species richness and functional traits and, for this reason, they are an important target group for studying the modification of forests over time. The datasets consist of annotated checklists and were published on Zenodo repository. NEW INFORMATION: Overall, 1,171 records are published, corresponding to 918 taxa (taxonomy at species or subspecies level). The taxa are scarcely shared amongst the areas, 80.2% of them are exclusive, indicating that the beetle communities are substantially different. In consideration of the biodiversity crisis we are passing through, which is especially dramatic for the insects, we want to promotecollaboration amongst researchers for making datasets available in open repositories. This will improve the possibility for researchers and forest managers of analysing the state of species distribution that could serve for long-term studies on the variation of insect communities. We encourage repeating species assessment in the same localities in order to evaluate the trends in insect communities over time and space.

Panchromatic Fluorescence Emission from Thienosquaraines Dyes: White Light Electrofluorochromic Devices.

Electrofluorochromic devices (EFCDs) that allow the modulation of the light emitted by electroactive fluorophores are very attractive in the research field of optoelectronics. Here, the electrofluorochromic behaviour of a series of squaraine dyes was studied for the first time. In solutions, all compounds are photoluminescent with maxima located in the range 665-690 nm, characterized by quantum yields ranging from 30% to 4.1%. Squaraines were incorporated in a polymer gel used as an active layer in all-in-one gel switchable EFCDs. An aggregation induced quenching occurs in the gel phase, causing a significant decrease in the emission quantum yield in the device. However, the squaraines containing the thieno groups (thienosquaraines, TSQs) show a panchromatic emission and their electrofluorochromism allows the tuning of the fluorescence intensity from 500 nm to the near infrared. Indeed, the application of a potential difference to the device induces a reversible quenching of their emission that is significantly higher and occurs at shorter switching times for TSQs-based devices compared to the reference squaraine dye (DIBSQ). Interestingly, the TSQs fluorescence spectral profile becomes more structured under voltage, and this could be explained by the shift of the aggregates/monomer equilibrium toward the monomeric species, due to electrochemical oxidation, which causes the disassembling of aggregates. This effect may be used to modulate the colour of the fluorescence light emitted by a device and paves the way for conceiving new electrofluorochromic materials based on this mechanism.

Baltic amber: A new Cacomorphocerus Schaufuss, 1892 with two specimens preserved in a single piece, and four new Malthodes Kiesenwetter, 1852.

The Baltic amber has proven to be an incredible resource for the environmental and faunistic diversity of the Eocene and this is also evident from the vast amount of Cantharidae species (soldier beetles) described as inclusions in this resin and Fossil-Lagerstätte. The present work contributes to highlighting both this trend and the variety of forms in particular for the genus Malthodes Kiesenwetter, 1852 with four new species described and with the addition of a new species of Cacomorphocerus Schaufuss, 1892 with two specimens included in the same amber piece. The new forms, described and illustrated here, are: Cacomorphocerus obstinatus sp. nov., Malthodes giannii sp. nov., Malthodes immortalis sp. nov., Malthodes marialuisae sp. nov., and Malthodes unimol sp. nov.

Electrochromic behaviour of Ir(iii) bis-cyclometalated 1,2-dioxolene tetra-halo complexes: fully reversible catecholate/semiquinone redox switches.

Neutral cyclometalated Ir(iii) complexes of general formula [Ir(ppy)2(O^O)squi], where ppy = 2-phenylpyridine and (O^O)squi = TBC (tetrabromocatechol) or TCC (tetrachlorocatechol) in their semiquinone (squi) monoanionic redox state, were synthesized by chemically oxidizing the anionic parent complexes NBu4[Ir(ppy)2(O^O)cat], in which (O^O)cat represents the corresponding ancillary dioxolene ligand in its dianionic catecholate (cat) redox state. This chemical oxidation leads to the modification of both the photophysical and the magnetic properties of the complexes. While the NBu4[Ir(ppy)2(O^O)cat] complexes are diamagnetic (D) and yellow-orange solids, the corresponding oxidized complexes [Ir(ppy)2(O^O)squi] display paramagnetic (P) properties and are characterized by a dark-green color. The conversion between the two forms (squi vs. cat) is electrochemically and chemically fully reversible. Indeed, the anionic NBu4[Ir(ppy)2(O^O)cat] complexes are quantitatively restored by chemical reduction of the neutral [Ir(ppy)2(O^O)squi] parents. These complexes therefore represent interesting redox based switches between multi-parameter states since they allow switching from a neutral paramagnetic to an anionic diamagnetic form together with a significant change in chromicity. Taking advantage of the significant color difference between the oxidized and the reduced form, an electrochromic cell was prepared with [Ir(ppy)2(TBC)squi] and its spectroelectrochemical properties are reported.

Delayed appearance of 3-methylglutaconic aciduria in neonates with early onset metabolic cardiomyopathies: A potential pitfall for the diagnosis.

Infantile onset cardiomyopathies are highly heterogeneous with several phenocopies compared with adult cardiomyopathies. Multidisciplinary management is essential in determining the underlying etiology in children's cardiomyopathy. Elevated urinary excretion of 3-methylglutaconic acid (3-MGA) is a useful tool in identifying the etiology in some metabolic cardiomyopathy. Here, we report the delayed appearance of 3-MGA-uria, between 6 and 18 months in three patients (out of 100 childhood onset cardiomyopathy) with neonatal onset cardiomyopathy, secondary to TMEM70 mutations and TAZ mutations (Barth syndrome), in whom extensive metabolic investigations, performed in the first weeks of life, did not display 3-MGA-uria. Serial retrospective evaluations showed full characteristic features of TMEM70 and TAZ mutations (Barth syndrome) in these three patients, including a clearly abnormal monolysocardiolipin/cardiolipin ratio in the two Barth syndrome patients. Serially repeated metabolic investigations finally discovered the 3-MGA-uria biomarker in all three patients between the age of 6 and 18 months. Our observation provides novel insights into the temporal appearance of 3-MGA-uria in TMEM70 and TAZ mutations (Barth syndrome) and focus the importance of multidisciplinary management and careful evaluation of family history and red flag signs for phenocopies in infantile onset cardiomyopathies.

A new fossil Malthodes Kiesenwetter, 1852 from the Eocene Baltic amber (Coleoptera Cantharidae).

A new Malthodes embedded in an amber piece of the Eocene from Kaliningrad region (Russia) is illustrated and described here. Most of the species of this genus, both living and fossil, show short elytra leaving some abdominal segments uncovered, as in the case of Malthodes tognettii sp. nov. The new species is characterized by the absence of the yellow spots on the elytral apex, the last sternite strongly curved and folded backward with weakly forked apex, and by the last tergite elongate, weakly forked apically and slightly bent downwards from half-length. A key of the Malthodes embedded in Baltic amber is also provided.

Efficacy and safety of tacrolimus in de novo pediatric transplant recipients randomized to receive immediate- or prolonged-release tacrolimus.

BACKGROUND AND AIMS: This multicenter trial compared immediate-release tacrolimus (IR-T) vs prolonged-release tacrolimus (PR-T) in de novo kidney, liver, and heart transplant recipients aged <16 years. Each formulation had similar pharmacokinetic (PK) profiles. Follow-up efficacy and safety results are reported herein. MATERIALS AND METHODS: Patients, randomized 1:1, received once-daily, PR-T or twice-daily, IR-T within 4 days of surgery. After a 4-week PK assessment, patients continued randomized treatment for 48 additional weeks. At Year 1, efficacy assessments included the number of clinical acute rejections, biopsy-confirmed acute rejection (BCAR) episodes (including severity), patient and graft survival, and efficacy failure (composite of death, graft loss, BCAR, or unknown outcome). Adverse events were assessed throughout. RESULTS: The study included 44 children. At Year 1, mean ± standard deviation tacrolimus trough levels were 6.6 ± 2.2 and 5.4 ± 1.6 ng/mL, and there were 2 and 7 acute rejection episodes in the PR-T and IR-T groups, respectively. No cases of graft loss or death were reported during the study. The overall efficacy failure rate was 18.2% (PR-T n = 1; IR-T n = 7). CONCLUSIONS: In pediatric de novo solid organ recipients, the low incidence of BCAR and low efficacy failure rate suggest that PR-T-based immunosuppression is effective and well tolerated to 1-year post-transplantation.

Cardiovascular risk in scuba divers.

BACKGROUND: We evaluated the role of scuba diving on cardiovascular risk in a small group of divers. METHODS: We have enrolled 14 subjects (12 males and 1 female, mean age 49±12.2 years) undergone to scuba diving (one patient did not complete the period of observation due to the b-blocker treatment). We evaluated electrocardiographyc trace and we have measured QT and RR interval to calculate the QTc index (Bazzet, Fridericia, Hodges and Framingam index) and the Tpeak to Tend index and heart rate variability index before and after scuba diving activity. RESULTS: The results of our study confirm that there is a statistically significant improvement of the RR and QT index but there is not a statistically significant increase of the QTc index (QT interval normalized by heart rate) evaluated before and after scuba diving. In the same cohort of subjects, we have noted a not statistically significant improvement of Tpeak to Tend index. Our study has underlined a statistically significant modification of the SD1 and SD2 indices representative of parasympathetic and orthosympathic activity. Scuba diving activity seems to not be associated with a statistically significant variation of the cardiovascular risk. CONCLUSIONS: Our data confirm that non-linear analysis is characterized by a statistically significant variation of the neurovegetative tone mainly linked to an increased parasympathetic activity. However, further studies are necessary to elucidate these preliminary findings.

Optical coherence tomography evidence of macular ganglion cell-inner plexiform layer thinning in eyes with subretinal drusenoid deposits.

BACKGROUND/OBJECTIVES: The purpose of this study was to evaluate macular ganglion cell layer-inner plexiform layer (GCL-IPL) and choroidal thickness in early age-related macular degeneration (AMD) in eyes with subretinal drusenoid deposits (SDD). SUBJECTS/METHODS: Comprehensive ophthalmological examination was performed. Near infrared reflectance and raster images using enhanced depth imaging were acquired with spectral domain optical coherence tomography. Drusen and SDD were diagnosed based on raster scans and near infrared reflectance. GCL-IPL maps were generated with automated segmentation and choroidal thickness maps were obtained by manually delineating the choroid-scleral boundary. RESULTS: Forty-eight eyes from 48 patients (mean age 77.5 ± 5.7, range 68-90 years) with a diagnosis of early AMD and 42 eyes of 42 age-matched control subjects (mean age 76.9 ± 5.7, range 67-88 years) were included. Of these, 28 eyes (58.3%) had drusen alone, 4 eyes (8.3%) had SDD alone, and 16 eyes (33.3%) had drusen associated with SDD. Compared with controls, average choroidal thickness was significantly decreased in AMD eyes (P < 0.05). There was no significant difference in choroidal thickness in eyes with SDD with respect to those with drusen alone. GCL-IPL thickness was reduced in an annular pattern at the 3 and 6 mm macular areas in AMD patients with respect to controls (P < 0.05). GCL-IPL thickness at 3 mm was significantly reduced in eyes with SDD with respect to those with drusen alone (P = 0.03). CONCLUSIONS: The GCL-IPL is reduced in thickness with an annular pattern in early AMD and is significantly thinner in eyes with SDD.