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Age-related Macular DegenerationALSTAR2NCT04112667

Functionally Validated Structural Endpoints for Early AMD

An observational study of Age-related Macular Degeneration and Aging, run by Cynthia Owsley at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Delayed rod-mediated dark adaptation (RMDA), or delayed recovery of vision in a dark environment, is a functional biomarker (i.e., risk factor) for early age-related macular degeneration (AMD). Read more about this study

Who is it for?
Ages 20 years and olderHealthy volunteers can take part
Conditions the study is for
Age-related Macular Degeneration, Aging
What is being tested?
Normal Macular Health, Early Macular Degeneration and Young Normals
How many people
556 participants
Where
1 siteUnited States
Study dates
7 Oct 2019to 31 Oct 2024
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 20 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: group 1 is >=60 years old with normal macular health group 2 is >=60 years old with early AMD group 3 is 20-30 years old are Young Normals

Who may be able to join

  • For those in Normal Macular Health or Early AMD: aged ≥ 60 years; either have normal macular health in both eyes at baseline or have early AMD in one eye For Young Normals: aged 20-30 years old; normal macular health in both eyes.

Who cannot join

  • ANY EYE CONDITION OR DISEASE IN EITHER EITHER (OTHER THAN EARLY CATARACT) THAT CAN IMPAIR VISION INCLUDING:
  • diabetic retinopathy
  • glaucoma
  • ocular hypertension
  • history of retinal diseases (e.g., retinal vein occlusion, retinal degenerations)
  • optic neuritis
Show all 46Show fewer
  • corneal disease
  • previous ocular trauma or surgery
  • REFRACTIVE ERROR >- 6 DIOPTERS
  • NEUROLOGICAL CONDITIONS THAT CAN IMPAIR VISION OR JUDGEMENT INCLUDING:
  • multiple sclerosis
  • Parkinson disease
  • stroke
  • Alzheimer disease
  • seizure disorders
  • brain tumor
  • traumatic brain injury
  • PSYCHIATRIC DISORDERS THAT COULD IMPAIR THE ABILITY:
  • to follow simple directions
  • answer questions about health and functioning
  • or to provide informed consent
  • DIABETES
  • ANY MEDICAL CONDITION THAT CAUSES SIGNIFICANT FRALITY OR IS BELIEVED TO BE TERMINAL.
  • These are identical to those described above, except that it is acceptable for participants to have early AMD (AREDS 2-4) in one eye and be AREDS grade 1 or any stage of AMD in the fellow eye.
  • ANY EYE CONDITION OR DISEASE IN EITHER EYE (OTHER THAN EARLY CATARACT) THAT CAN IMPAIR VISION INCLUDING:
  • diabetic retinopathy
  • glaucoma
  • ocular hypertension
  • history of retinal diseases (e.g., retinal vein occlusion, retinal degenerations)
  • optic neuritis, corneal disease
  • previous ocular trauma or surgery
  • RERACTIVE ERROR >=6 DIOPTORS
  • NEUROLOGICAL CONDITIONS THAT CAN IMPAIR VISION OR JUDGEMENT INCLUDING:
  • multiple sclerosis
  • Parkinson disease
  • stroke
  • Alzheimer disease
  • seizure disorders
  • brain tumor
  • traumatic brain injury
  • PSYCHIATRIC DISORDERS THAT COULD IMPAIR THE ABILITY TO:
  • follow simple directions
  • answer questions about health and functioning
  • or to provide informed consent
  • DIABETES
  • ANY MEDICAL CONDITION THAT CAUSES SIGNIFICANT FRAILTY OR IS BELIEVED TO BE TERMINAL.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Alabama at Birmingham

    Birmingham, Alabama, 35294

Other trials in United States

About this study

Delayed rod-mediated dark adaptation (RMDA), or delayed recovery of vision in a dark environment, is a functional biomarker (i.e., risk factor) for early age-related macular degeneration (AMD). This research plan is designed to elucidate the structural (anatomical) basis of this visual deficit using cellular- and subcellular level imaging of the retina and its supporting tissues in living people. An accurate map and timeline of structure-function relationships in persons tested for night vision will result in functionally validated structural endpoints for early AMD trials, as well as define major biologic effects for development into future treatments.

Read the detailed description

The Alabama Study on Early Age-Related Macular Degeneration 2 (ALSTAR2) is a prospective cohort study with baseline measurements that are repeated at follow-up 3 years later. The baseline and 3 year follow-up visits will each consist of 2 visits for a total of 4 visits.

Study assessments are listed below. All are collected at two visits at both baseline and follow-up for 4 visits total (blood collection for DNA analysis at baseline only). For some functional tests (photopic and mesonic acuity, photopic and mesonic contrast sensitivity), each eye will be tested separately. For other functional tests (dark-adapted two-color perimetry, light-adapted cone-mediate perimetry, rod-mediated dark adaptation), only one eye will be tested, which will be designated by the study eye. Tropicamide 1% and phenylephrine hydrochloride 2.5% are used to dilate pupils (diameter of ≥ 6 mm) as needed for specific parts of the protocol. After completing the baseline visits, participants will receive an annual phone call from the study coordinator so that contact information can be updated. Participants will receive an annual newsletter containing study related information (this will be submitted to the IRB for approval).

Study Assessments:

  1. Rod-mediated dark adaptation (RMDA), the ability to recover light sensitivity after exposure to a bright light.
  2. Dark-adapted two-color microperimetry, a measure of light sensitivity for lights of two different colors.
  3. Photopic and mesopic acuity in central vision, as measured by letter charts..
  4. Photopic and mesopic contrast sensitivity in central vision, as measured by letter charts..
  5. Multimodal ocular imaging on both eyes, which consists of the following: color fundus photography, spectral domain optical coherence tomography (SDOCT), blue fundus autofluorescence (standard and quantitative), OCT-angiography (OCT-A).
  6. Blood draw for the analysis of C-reactive protein, high-density lipoprotein, carotenoid level, DNA extraction, and examination of the presence of genetic risk associated with age-related macular degeneration (AMD).
  7. Questionnaires: Demographics, medical co-morbidities, cognitive status screen, medication use, alcohol use, smoking, self-reported visual difficulty in the visual activities of daily living

The Young normal group will only complete:

  1. Rod-mediated dark adaptation (RMDA), the ability to recover light sensitivity after exposure to a bright light.
  2. Dark-adapted two-color microperimetry, a measure of light sensitivity for lights of two different colors.
  3. . Photopic and mesopic acuity in central vision, as measured by letter charts..
  4. Photopic and mesopic contrast sensitivity in central vision, as measured by letter charts..
  5. Multimodal ocular imaging on both eyes, which consists of the following: color fundus photography, spectral domain optical coherence tomography (SDOCT), blue fundus autofluorescence (standard and quantitative),OCT-angiography (OCT-A).d and quantitative), OCT-angiography.
Being tested
Normal Macular Health, Early Macular Degeneration, Young Normals
Keywords
vision, retina, dark adaptation, light sensitivity, spectral domain optical coherence tomography, quantitative autofluorescence, optical coherence tomography angiography
Medical subject headings
Macular Degeneration, Photophobia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Normal Macular HealthOther

    This group of participants will have function assessed using rod- and cone-mediated tests (rod-mediated dark adaptation, 2 color dark adapted perimetry, cone-mediated perimetry, photopic and mesopic acuity, photopic and mesopic contrast sensitivity). Age-related macular degeneration status will be determined by multi-modal imaging.

  • Early Macular DegenerationOther

    This group of participants will have function assessed using rod- and cone-mediated tests (rod-mediated dark adaptation, 2 color dark adapted perimetry, cone-mediated perimetry, photopic and mesopic acuity, photopic and mesopic contrast sensitivity). Age-related macular degeneration status will be determined by multi-modal imaging.

  • Young NormalsOther

    This group of participants will have function assessed using rod- and cone-mediated tests (rod-mediated dark adaptation, 2 color dark adapted perimetry, cone-mediated perimetry, photopic and mesopic acuity, photopic and mesopic contrast sensitivity). Age-related macular degeneration status will be determined by multi-modal imaging.

Study groups in NCT04112667
Study groupRoleWhat they receive
Normal Macular Health>=60 years old with no macular disease
Receives: Other: Normal Macular Health
Early Macular Degeneration>=60 years old with early age-related macular degeneration
Receives: Other: Early Macular Degeneration
Young Normals20-30 years old with normal macular health
Receives: Other: Young Normals

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Rod-mediated dark adaptation

    Time required to recover light sensitivity after exposure to bright light

    Measured: Measured at baseline enrollment

  2. Rod-mediated dark adaptation

    Time required to recover light sensitivity after exposure to bright light

    Measured: Measured at 3 years after baseline enrollment

  3. incident age-related macular degeneration (AMD) or progression of AMD using multimodal imaging

    development of AMD or progression of AMD at the 3 year follow up visit

    Measured: Measured at baseline enrollment

  4. incident age-related macular degeneration (AMD) or progression of AMD using multimodal imaging

    development of AMD or progression of AMD at the 3 year follow up visit

    Measured: Measured at 3 years after baseline enrollment

Secondary outcomes (6)
  1. Light sensitivity as measured by microperimetry and perimetry

    Amount of light needed to detect a small target object

    Measured: Measured at baseline enrollment

  2. Light sensitivity as measured by microperimetry and perimetry

    Amount of light needed to detect a small target object

    Measured: Measured at 3 years after baseline enrollment

  3. Photopic and mesopic acuity

    Visual acuity under day time and twilight conditions

    Measured: Measured at baseline enrollment

  4. Photopic and mesopic acuity

    Visual acuity under day time and twilight conditions

    Measured: Measured at 3 years after baseline enrollment

  5. Photopic and mesopic contrast sensitivity

    Amount of contrast needed to recognize a letter under day time and twilight conditions

    Measured: Measured at baseline enrollment

  6. Photopic and mesopic contrast sensitivity

    Amount of contrast needed to recognize a letter under day time and twilight conditions

    Measured: Measured at 3 years after baseline enrollment

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Oct 2019
  2. Study start7 Oct 2019
  3. Primary completion1 Jul 2024
  4. Study completion31 Oct 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
556 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04112667
Sponsor's protocol ID
IRB-300003067
Other IDs
1R01EY029595
Acronym
ALSTAR2
Status last verified
Jun 2025
First submitted
30 Sep 2019
Last updated
26 Sep 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Currently there is no plan to make individual participant data available to other researchers.

Publications

  • Owsley C, Curcio CA. Impaired Rod-Mediated Vision is the Functional Hallmark of Ageing and Early and Intermediate Age-Related Macular Degeneration. Ophthalmic Physiol Opt. 2026 Jun 22. doi: 10.1007/s44402-026-00124-1. Online ahead of print.

    PubMed 42332292
  • Emamverdi M, Vatanatham C, Fasih-Ahmad S, Wang Z, Mishra Z, Jain A, Ganegoda A, Clark ME, Habibi A, Ashrafkhorasani M, Owsley C, Curcio CA, Hu ZJ, Sadda SR. Probing Deposit-Driven Age-Related Macular Degeneration Via Thicknesses of Outer Retinal Bands and Choroid: ALSTAR2 Baseline. Invest Ophthalmol Vis Sci. 2024 May 1;65(5):17. doi: 10.1167/iovs.65.5.17.

    PubMed 38717424
  • Kar D, Corradetti G, Swain TA, Clark ME, McGwin G Jr, Owsley C, Sadda SR, Curcio CA. Choriocapillaris Impairment Is Associated With Delayed Rod-Mediated Dark Adaptation in Age-Related Macular Degeneration. Invest Ophthalmol Vis Sci. 2023 Sep 1;64(12):41. doi: 10.1167/iovs.64.12.41.

    PubMed 37768273
  • Berlin A, Matney E, Jones SG, Clark ME, Swain TA, McGwin G Jr, Martindale RM, Sloan KR, Owsley C, Curcio CA. Discernibility of the Interdigitation Zone (IZ), a Potential Optical Coherence Tomography (OCT) Biomarker for Visual Dysfunction in Aging. Curr Eye Res. 2023 Nov;48(11):1050-1056. doi: 10.1080/02713683.2023.2240547. Epub 2023 Aug 4.

    PubMed 37539829
  • McGwin G Jr, Kar D, Berlin A, Clark ME, Swain TA, Crosson JN, Sloan KR, Owsley C, Curcio CA. Macular and Plasma Xanthophylls Are Higher in Age-related Macular Degeneration than in Normal Aging: Alabama Study on Early Age-related Macular Degeneration 2 Baseline. Ophthalmol Sci. 2022 Dec 22;3(2):100263. doi: 10.1016/j.xops.2022.100263. eCollection 2023 Jun.

    PubMed 36864830
  • Curcio CA, McGwin G Jr, Sadda SR, Hu Z, Clark ME, Sloan KR, Swain T, Crosson JN, Owsley C. Functionally validated imaging endpoints in the Alabama study on early age-related macular degeneration 2 (ALSTAR2): design and methods. BMC Ophthalmol. 2020 May 19;20(1):196. doi: 10.1186/s12886-020-01467-0.

    PubMed 32429847

Questions about this trial

What is this clinical trial studying?

An observational study of Age-related Macular Degeneration and Aging, run by Cynthia Owsley at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 46 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 26 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Rod-mediated dark adaptation (time frame: Measured at baseline enrollment). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04112667, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Sep 2025.

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