Study WR42221 is a Phase IIIb, global, multicenter, randomized, visual assessor-masked study designed to assess the efficacy, safety, and pharmacokinetics of the Port Delivery System with ranibizumab (PDS) 100 mg/mL delivered every 36 weeks (Q36W) compared with every 24 weeks (Q24W) in patients with neovascular age-related macular degeneration (nAMD).

Inclusion Criteria:

• Age ≥ 50 years at time of signing Informed Consent Form
• Initial diagnosis of nAMD within 9 months prior to the screening visit
• Previous treatment with at least three anti- vascular endothelial growth factor (VEGF) intravitreal injections for nAMD per standard of care within 6 months prior to the screening visit
• Demonstrated response to prior anti-VEGF intravitreal treatment since diagnosis
• Availability of historical visual acuity data prior to the first anti-VEGF treatment for nAMD until the time of study enrollment
• BCVA of 34 letters (approximate 20/200 Snellen equivalent) or better

Exclusion Criteria:

• History of vitrectomy surgery, submacular surgery, or other surgical intervention for AMD in study eye
• Prior treatment with Visudyne®, external-beam radiation therapy, or transpupillary thermotherapy in study eye
• Previous treatment with corticosteroid intravitreal injection, intraocular device implantation, previous laser (any type) used for AMD treatment in study eye
• Treatment with anti-VEGF agents other than ranibizumab within 1 month prior to the enrollment visit in study eye
• Concurrent conjunctival, Tenon's capsule, and/or scleral condition in the supero-temporal quadrant of the eye that may affect the implantation, subsequent tissue coverage, and refill-exchange procedure of the PDS implant
• Prior treatment with brolucizumab (at any time prior to the screening visit) in either eye
• Prior participation in a clinical trial involving any anti-VEGF drugs, within 9 months prior to the enrollment visit in either eye
• Subretinal hemorrhage that involves the center of the fovea, if the hemorrhage is >0.5 disc area at screening in study eye
• Subfoveal fibrosis or subfoveal atrophy in study eye
• Choroidal neovascularization (CNV) due to other causes, such as ocular histoplasmosis, trauma, central serous chorio-retinopathy, or pathologic myopia in either eye
• Retinal pigment epithelial tear in study eye
• 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 in study eye
• Active intraocular inflammation in study eye
• History of vitreous hemorrhage in study eye
• History of rhegmatogenous retinal detachment in study eye
• History of retinal tears or peripheral retinal breaks within 3 months prior to the enrollment visit in study eye
• History of pars plana vitrectomy surgery
• Aphakia or absence of the posterior capsule in study eye
• Spherical equivalent of the refractive error demonstrating more than 8 diopters of myopia in study eye
• Preoperative refractive error that exceeded 8 diopters of myopia, for Participants who have undergone prior refractive or cataract surgery in study eye
• Intraocular surgery within 3 months preceding the enrollment visit in study eye
• Uncontrolled ocular hypertension or glaucoma and any such condition the investigator determines may require a glaucoma-filtering surgery during a participant's participation in the study in study eye
• History of glaucoma-filtering surgery, tube shunts, or microinvasive glaucoma surgery in study eye
• History of corneal transplant in study eye
• Any history of uveitis requiring treatment in either eye
• Active infectious conjunctivitis, keratitis, scleritis, or endophthalmitis in either eye
• Uncontrolled blood pressure
• History of stroke within the last 3 months prior to informed consent
• Atrial fibrillation diagnosed or worsened within the last 3 months prior to informed consent
• History of myocardial infarction within the last 3 months prior to informed consent,
• 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 participant at high risk of treatment complications in the opinion of the investigator
• Confirmed active systemic infection
• Use of any systemic anti-VEGF agents
• 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 disease studies of investigational drugs within 1 month preceding the informed consent
• Non-functioning non-study eye

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

• The BCVA examiner will only conduct refraction and BCVA assessments and will be masked to participant study eye assignment and study visit type.
• The BCVA examiner will have no access to a participant's BCVA scores from previous visits and will be aware only of the participant's refraction data from previous visits.
• The BCVA examiner may provide no other direct or indirect participant care.