A Study Assessing Corneal Endothelial Cells in Participants With Neovascular Age-related Macular Degeneration (nAMD) Treated With the Port Delivery System With Ranibizumab (PDS) (Belvedere)

A Phase IV, Multicenter, Open-label Study to Assess Corneal Endothelial Cells in Patients With Neovascular Age-related Macular Degeneration Treated With the Port Delivery System With Ranibizumab (PDS)

This study will assess corneal endothelial cells in participants with nAMD treated with PDS refilled every 24 weeks (Q24W).

Study Overview

• Status: Recruiting
• Conditions: Neovascular Age-related Macular Degeneration
• Intervention / Treatment: Device: PDS Implant With Ranibizumab 100 mg/ml; Drug: LUCENTIS (Ranibizumab Injection)

• Study Type: Interventional
• Enrollment (Estimated): 188
• Phase: Phase 4

Contacts and Locations

• Study Contact: Name: Reference Study ID Number: ML43000 https://forpatients.roche.com/; Phone Number: 888-662-6728 (U.S.); Email: global-roche-genentech-trials@gene.com

Study Locations

• United States
  • Arizona
    • Mesa, Arizona, United States, 85206-2747
      • Recruiting
      • Barnet Dulaney Perkins Eye Center
  • California
    • Bakersfield, California, United States, 93309
      • Completed
      • California Retina Consultants
    • Huntington Beach, California, United States, 92647
      • Recruiting
      • Retina Associates of Southern California
    • Pasadena, California, United States, 91107-3747
      • Completed
      • California Eye Specialists Medical Group Inc.
    • Sacramento, California, United States, 95841-2013
      • Recruiting
      • Retinal Consultants Med Group
    • San Francisco, California, United States, 94158-2510
      • Recruiting
      • University of California San Francisco
    • Santa Ana, California, United States, 92705-6504
      • Recruiting
      • Orange County Retina Med Group
    • Torrance, California, United States, 90503-3270
      • Recruiting
      • Macula Retina Vitreous Research Institute
  • Colorado
    • Durango, Colorado, United States, 81303
      • Completed
      • Southwest Retina Consultants
    • Longmont, Colorado, United States, 80503-6499
      • Recruiting
      • Advanced Vision Research Institute
  • Connecticut
    • Waterford, Connecticut, United States, 06385-1215
      • Withdrawn
      • Retina Group of New England
  • Florida
    • Pensacola, Florida, United States, 32503-2030
      • Recruiting
      • Retina Specialty Institute
    • Plantation, Florida, United States, 33324-3118
      • Withdrawn
      • Ft Lauderdale Eye Institute
    • St. Petersburg, Florida, United States, 33711-1141
      • Recruiting
      • Retina Vitreous Associates of Florida
  • Georgia
    • Augusta, Georgia, United States, 30909-6440
      • Recruiting
      • Southeast Retina Center
  • Illinois
    • Lemont, Illinois, United States, 60439-7421
      • Recruiting
      • University Retina and Macula Associates, PC
  • Iowa
    • West Des Moines, Iowa, United States, 50266
      • Withdrawn
      • Wolfe Eye Clinic
  • Kentucky
    • Lexington, Kentucky, United States, 40509-1827
      • Withdrawn
      • Retina Associates of Kentucky
  • Maine
    • Portland, Maine, United States, 04101
      • Recruiting
      • Maine Eye Center
  • Maryland
    • Baltimore, Maryland, United States, 21287-0005
      • Recruiting
      • Wilmer Eye Institute Johns Hopkins University
    • Baltimore, Maryland, United States, 21209-2219
      • Recruiting
      • The Retina Care Center
    • Chevy Chase, Maryland, United States, 20815-6956
      • Withdrawn
      • Retina Group of Washington
    • Hagerstown, Maryland, United States, 21740
      • Completed
      • Cumberland Valley Retina Consultants PC
  • Michigan
    • Royal Oak, Michigan, United States, 48073
      • Recruiting
      • Associated Retinal Consultants PC
  • Minnesota
    • Minneapolis, Minnesota, United States, 55435-3004
      • Recruiting
      • VitreoRetinal Surgery, PLLC.
  • Missouri
    • Chesterfield, Missouri, United States, 63017-5065
      • Completed
      • Midwest Vision Research Foundation
  • Nevada
    • Reno, Nevada, United States, 89502-1605
      • Recruiting
      • Sierra Eye Associates
  • New Jersey
    • Bloomfield, New Jersey, United States, 07003
      • Recruiting
      • Envision Ocular, LLC
  • New York
    • Poughkeepsie, New York, United States, 12603-2416
      • Recruiting
      • Seeta Eye Centers
  • North Carolina
    • Asheville, North Carolina, United States, 28803-2493
      • Withdrawn
      • Western Carolina Retinal Associate PA
    • Durham, North Carolina, United States, 27705-4699
      • Recruiting
      • Duke Eye Center
  • North Dakota
    • Fargo, North Dakota, United States, 58047
      • Recruiting
      • Fargo Retina Consultants
  • Ohio
    • Blue Ash, Ohio, United States, 45242-5537
      • Recruiting
      • Cincinnati Eye Institute
    • Cleveland, Ohio, United States, 44195
      • Recruiting
      • Cleveland Clinic
  • Oklahoma
    • Tulsa, Oklahoma, United States, 74114
      • Withdrawn
      • Tulsa Retina Consultants
  • Pennsylvania
    • Erie, Pennsylvania, United States, 16505
      • Recruiting
      • Erie Retina Research
    • Philadelphia, Pennsylvania, United States, 19107-5109
      • Withdrawn
      • Mid Atlantic Retina
  • South Carolina
    • Florence, South Carolina, United States, 29501
      • Withdrawn
      • Palmetto Retina Center
    • West Columbia, South Carolina, United States, 29169-2429
      • Withdrawn
      • Palmetto Retina Center, LLC
  • Tennessee
    • Germantown, Tennessee, United States, 38138-2405
      • Recruiting
      • Charles Retina Institute
    • Nashville, Tennessee, United States, 37203-1596
      • Recruiting
      • Tennessee Retina PC
  • Texas
    • Amarillo, Texas, United States, 79106-1835
      • Completed
      • Panhandle Eye Group LLP Southwest Retina Specialists
    • Austin, Texas, United States, 78705-1169
      • Withdrawn
      • Austin Retina Associates
    • Bellaire, Texas, United States, 77401
      • Recruiting
      • Retina Consultants of Texas
    • Schertz, Texas, United States, 78154
      • Recruiting
      • Retina Consultants of Texas
  • Utah
    • Salt Lake City, Utah, United States, 84107-6767
      • Recruiting
      • Retina Associates of Utah, PLLC
  • Virginia
    • Lynchburg, Virginia, United States, 24502-4271
      • Recruiting
      • Piedmont Eye Center
    • Norfolk, Virginia, United States, 23502-3933
      • Recruiting
      • Wagner Kapoor Institute
    • Richmond, Virginia, United States, 23235-1962
      • Withdrawn
      • Retina Institute of Virginia
  • Washington
    • Spokane, Washington, United States, 99204
      • Recruiting
      • Spokane Eye Clinical Research

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 50 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria

Ocular Inclusion Criteria:

• Diagnosis of nAMD prior to screening as determined by the investigator
• Difference of <10% in ECD at screening between the 2 eyes as measured by specular microscopy and determined by the independent reading center
• Availability of historical visual acuity (VA) data and spectral-domain optical coherence tomography (SD-OCT). Additionally, fluorescein angiography or color fundus photography can both be used to support participant eligibility per protocol at investigator discretion
• Availability of comprehensive historical anti-vascular endothelial growth factor (VEGF) injection data, including agent administered and date of administration from the time of diagnosis, or for at least 2 years prior to screening if diagnosis was made more than 2 years before screening

• Response to at least two prior anti-VEGF IVT injections as determined by the investigator based on the following:

  • Overall decrease in nAMD disease activity detected on historical or screening OCT
  • Stable or improved best-corrected visual acuity (BCVA)
• BCVA of 34 letters (approximate 20/200 Snellen equivalent) or better, using Early Treatment of Diabetic Retinopathy Study (ETDRS) chart at a starting distance of 4 meters at screening and enrollment
• All subtypes of nAMD lesions are permissible
• nAMD lesions at the time of diagnosis must involve the macula
• Sufficiently clear ocular media and adequate pupillary dilation to allow for clinical examination and analysis and grading by the central reading center of SD-OCT images

Exclusion Criteria

Prior Ocular Treatment

Study Eye:

• Prior treatment with external-beam radiation therapy or transpupillary thermotherapy
• Previous treatment with verteporfin injection (PDT) or corticosteroid IVT injection within 2 years of screening
• Previous laser (except PDT as stated above) used for age related macular degeneration (AMD) treatment
• History of corneal transplant
• History of conjunctival surgery in the superotemporal quadrant
• History of intraocular inflammation following anti-VEGF injection

Either Eye:

• Previous PDS implantation
• Previous intraocular surgery (including cataract surgery) within 6 months of study enrollment
• Prior vitrectomy surgery, submacular surgery, or other surgical intervention for age-related macular degeneration (AMD)
• Prior pars plana vitrectomy surgery
• Previous intraocular device implantation, excluding intraocular lenses
• History of glaucoma-filtering surgery, tube shunts, or microinvasive glaucoma surgery
• Prior participation in a clinical trial involving any intravitreal agents that are not approved at time of screening
• Intraocular laser therapy, including selective laser trabeculoplasty, yttrium-aluminum garnet (YAG), prophylactic peripheral iridotomy within 1 year of screening, or YAG capsulotomy within 3 months of screening
• Contact lens wear in either eye within 2 months of screening
• Any prior penetrating ocular trauma
• Any prior ocular blunt trauma affecting corneal or retinal health in the opinion of the investigator, or any ocular blunt trauma within 6 months of screening
• History of corneal transplantation, including partial-thickness corneal grafts
• Prior treatment with brolucizumab
• Prior treatment with external-beam radiation therapy or brachytherapy
• History of hypersensitivity to ranibizumab or any excipients of Susvimo

Macular Neovascularization Lesion (MNV) Characteristics

Study Eye:

• Subretinal hemorrhage that involves the center of the fovea, if the hemorrhage is greater than 0.5-disc area [1.27 square millimeters (mm^2)] in size
• Subfoveal fibrosis or subfoveal atrophy

Either Eye:

• MNV due to other causes, such as ocular histoplasmosis, trauma, or pathologic myopia
• MNV masquerading lesions (e.g., cone dystrophy, adult vitelliform dystrophy, pattern dystrophy)

Current or Historical Ocular Conditions

Study Eye:

• Retinal pigment epithelial tear
• Retinal tears or peripheral retinal breaks on depressed fundus exam that are untreated, or treated within the 3 months prior to study enrollment
• Current vitreous hemorrhage
• Current or history of retinal detachment
• Previous violation of the posterior capsule is also an exclusion criterion unless it occurred as a result of YAG laser posterior capsulotomy in association with prior, posterior chamber intraocular lens implantation
• Spherical equivalent of the refractive error demonstrating more than 8 diopters of myopia or evidence of pathologic myopia on depressed fundus examination
• Preoperative refractive error that exceeds 8 diopters of myopia, for participants who have undergone prior refractive or cataract surgery
• Spherical equivalent of the refractive error demonstrating more than 5 diopters of hyperopia
• Preoperative refractive error that exceeds 5 diopters of hyperopia, for participants who have undergone prior refractive or cataract surgery
• Uncontrolled ocular hypertension or glaucoma and any such condition the investigator determines may require a glaucoma-filtering surgery during a patient's participation in the study
• Scleral pathology in the superotemporal quadrant (e.g., scleral thinning or calcification)
• Conjunctival pathologies in the superotemporal quadrant
• History or presence of severe posterior blepharitis, recurrent chalazia or hordeolum, severe dry eye syndrome, or severe allergic conjunctivitis
• Ectropion, entropion or other impairment of the upper or lower eyelid impacting lid functionality needed to protect the ocular surface from exposure
• Trichiasis
• Corneal neuropathy
• Lagophthalmos or incomplete blink
• Active or history of facial nerve palsy/paresis

Fellow (Non-Study) Eye:

• Concurrent or history of PDS implantation

Either Eye:

• Aphakia or absence of the posterior capsule
• Any concurrent intraocular condition that would either require surgical intervention during the study to prevent or treat visual loss that might result from that condition or affect interpretation of study results
• Corneal ECD ≤1500 cells/mm2 in either eye at screening as determined by the independent reading center
• Fuchs endothelial corneal dystrophy Grade ≥ 2
• Previous corneal endothelial cell damage, including from blunt or surgical trauma
• Any ocular condition that precludes obtaining an analyzable specular microscopy image
• Active or history of corneal edema
• Active or history of corneal dystrophies
• Active or history of iridocorneal endothelial syndrome
• Active or history of pseudoexfoliation syndrome
• Active or history of herpetic keratitis or kerato-uveitis
• Any active or history of uveitis
• Active intraocular inflammation
• Active or history of keratitis, scleritis, or endophthalmitis
• Active ocular or periocular infection
• Active or history of Sjogren's syndrome or keratoconjunctivitis sicca
• Active or history of floppy eyelid syndrome
• Active or history of chronic eye rubbing
• Active thyroid eye disease

Concurrent Systemic Conditions:

• History of uncontrolled blood pressure
• Active or history of autoimmune diseases such as rheumatoid arthritis, lupus, granulomatosis with polyangiitis (Wegener's)
• History of stroke within the last 3 months prior to screening
• Uncontrolled atrial fibrillation within 3 months of screening
• History of myocardial infarction within the last 3 months prior to screening
• History of other disease, metabolic dysfunction, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of ranibizumab or placement of the implant and that might affect interpretation of the results of the study or renders the patient at high risk of treatment complications, in the opinion of the investigator
• Current active systemic infection
• Use of any systemic anti-VEGF agents
• Chronic use of oral corticosteroids
• Active cancer within 12 months of enrollment except for appropriately treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, and prostate cancer with a Gleason score of ≤ 6 and a stable prostate-specific antigen for > 12 months
• Previous participation in any non-ocular (systemic) disease studies of investigational drugs within 1 month prior to screening (excluding vitamins and minerals)
• Use of antimitotic or antimetabolite therapy within 30 days or 5 elimination half-lives of the screening visit
• Requirement for continuous use of any medications or treatments indicated as prohibited therapy
• Pregnant or breastfeeding, or intention to become pregnant during the study
• Women of childbearing potential must have a negative urine pregnancy test result within 28 days prior to initiation of study treatment. If the urine pregnancy test is positive, it must be confirmed by a serum pregnancy test

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: SUSVIMO; Participants will have the PDS implant (filled prior to implantation with approximately 20 microlitres [uL] of the 100 milligrams/millilitres [mg/ml] formulation of ranibizumab [approximately 2 milligrams (mg) dose of ranibizumab]) surgically inserted in the study eye at the Day 1 visit following their enrollment visit. After the initial fill of the implant with ranibizumab, participants will receive implant refill-exchanges at fixed Q24W intervals.

Device: PDS Implant With Ranibizumab 100 mg/ml; Ranibizumab 100 mg/mL will be delivered via PDS; Drug: LUCENTIS (Ranibizumab Injection); Ranibizumab (0.5 mg intravitreal [IVT] injections of 10 mg/mL formulation) will be used in the study eye as supplemental treatment. If a participant discontinues study treatment, he/she may start receiving IVT ranibizumab injections in the study eye, per investigator's discretion.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Percent Change in Corneal Endothelial Cell Density (ECD) From Baseline at Week 48 in the Study Eye as Compared With the Fellow Eye, as Assessed by Specular Microscopy	Baseline, Week 48

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Percent Change in Corneal ECD From Baseline at Week 24 in the Study Eye as Compared With the Fellow Eye		Baseline, Week 24
Percent Change in the Coefficient of Variation (CV) of Corneal Endothelial Cell Area From Baseline at Weeks 24 and 48 in the Study Eye as Compared With the Fellow Eye		Baseline, Week 24, Week 48
Percent Change in Hexagonal Cells (HEX) From Baseline at Weeks 24 and 48 in the Study Eye as Compared With the Fellow Eye		Baseline, Week 24, Week 48
Percentage of Participants With Ocular Serious Adverse Events (SAEs) and Severity of SAEs		Day 1 up to approximately Week 52
Percentage of Participants With Ocular Adverse Events of Special Interests (AESIs) and Severity of Ocular AESIs		Day 1 to Week 52
Duration of Ocular AESIs		Day 1 to Week 52
Percentage of Participants With Ocular AESIs During the Postoperative Period		Baseline up to 37 days of initial implantation
Percentage of Participants With Ocular AESIs During the Intermediate Postoperative Period		38 to 93 days after implantation
Percentage of Participants With Ocular AESIs During the Follow-up Period	The investigator will follow each adverse event (AE) until the event has resolved to baseline grade or better, the event is assessed as stable by the investigator, the participant is lost to follow-up, or the participant withdraws consent.	Week 52
Percentage of Participants With Adverse Device Effects (ADEs)		Day 1 to Week 52
Number of Participants with Anticipated Serious Adverse Device Effects (ASADEs) and Severity of ASADEs		Day 1 to Week 52
Duration of ASADEs		Day 1 to Week 52

Collaborators and Investigators

• Sponsor: Genentech, Inc.
• Investigators: Study Director: Clinical Trials, Genentech, Inc.

Study record dates

Study Major Dates

• Study Start (Actual): December 14, 2021
• Primary Completion (Estimated): September 30, 2027
• Study Completion (Estimated): October 29, 2027

Study Registration Dates

• First Submitted: April 16, 2021
• First Submitted That Met QC Criteria: April 16, 2021
• First Posted (Actual): April 21, 2021

Study Record Updates

• Last Update Posted (Actual): May 12, 2026
• Last Update Submitted That Met QC Criteria: May 11, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Eye Diseases; Retinal Diseases; Retinal Degeneration; Macular Degeneration; Wet Macular Degeneration; Amino Acids, Peptides, and Proteins; Proteins; Antibodies, Monoclonal, Humanized; Antibodies, Monoclonal; Antibodies; Immunoglobulins; Immunoproteins; Blood Proteins; Serum Globulins; Globulins; Ranibizumab
• Other Study ID Numbers: ML43000

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: For eligible studies, qualified researchers may request access to individual patient level clinical data. See Roche's commitment to transparency of clinical study information here: https://go.roche.com/data_sharing

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: Yes
• product manufactured in and exported from the U.S.: Yes