Ranibizumab Port Delivery System shows comparable visual and anatomical outcomes to monthly ranibizumab in nAMDPort Delivery System Shows Similar Results to Monthly Eye Injections

Seminars in ophthalmology Published November 6, 2026 Study authors: Dogru Edhem, Chavez Matheus Pedrotti, Toth Otávio, Serafini Mirella, Kabaalioglu Guner Melis PubMed ↗ DOI ↗ Editorial oversight: Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

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Key Takeaway

Note that ranibizumab PDS provides comparable visual outcomes to monthly ranibizumab but carries higher ocular AE risk.

This meta-analysis evaluated the efficacy and safety of the ranibizumab Port Delivery System (PDS) compared to monthly intravitreal ranibizumab (0.5 mg) in patients with neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). The analysis included 1,149 eyes to assess primary and secondary outcomes including Best Corrected Visual Acuity (BCVA) and Central Retinal Thickness (CRT).

For patients with nAMD, no significant differences were found in BCVA (MD -0.69 letters; 95% CI -2.52 to 1.14; p=0.46) or CRT (MD 26.67 µm; 95% CI -16.55 to 69.88; p=0.23). Similarly, for patients with DME, no significant differences were observed in BCVA (MD 0.20; 95% CI -1.20 to 1.60; p=0.78) or CRT (MD -3.80; 95% CI -17.20 to 9.60; p=0.58).

Safety data indicated that ocular adverse events were significantly higher with the PDS (RR 1.80; 95% CI 1.49-2.17; p<0.00001), while systemic adverse events were comparable between groups (RR 1.00; 95% CI 0.89-1.13; p=0.98). A noted limitation is that the evidence for the DME population was limited to a single trial. Clinicians should note that while PDS offers comparable visual and anatomical results to monthly ranibizumab in nAMD, it is associated with a higher incidence of procedure- and device-related ocular complications.

How this fits prior evidence

This meta-analysis extends the existing evidence that ranibizumab PDS provides noninferior BCVA gains in diabetic retinopathy. It also confirms that ranibizumab PDS offers comparable visual and anatomical outcomes to monthly ranibizumab in nAMD, though it carries a higher risk of ocular adverse events. The findings for the DME population should be considered exploratory due to the limited evidence from a single trial.

Researchers looked at how a Port Delivery System (PDS) compares to monthly injections of ranibizumab for people with neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). The study analyzed 1,149 eyes to see if the delivery method changed visual outcomes or the thickness of the retina.

The results showed no significant difference in vision or retinal thickness between the PDS and monthly injections for patients with nAMD. For those with DME, the results were also similar, though the data for this specific group came from only one trial.

While the vision results were comparable, the study found a significant difference in safety. Patients using the PDS had a much higher rate of local eye complications compared to those receiving monthly injections. Because of these risks, the findings for the DME group are currently considered exploratory. Patients should discuss these delivery methods and potential risks with their eye specialist.

What this means for you:

PDS offers similar vision results to monthly injections but has a higher risk of local eye complications.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedNov 2026

PMID42360009

View Original Abstract ↓

PURPOSE: The comparative efficacy and safety of ranibizumab Port Delivery System (PDS) vs monthly intravitreal ranibizumab in Vascular Endothelial Growth Factor (VEGF)-driven macular diseases remains uncertain. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing PDS vs monthly ranibizumab in neovascular age-related macular degeneration (nAMD) or diabetic macular edema (DME). METHODS: PubMed, Embase, and Cochrane were searched for randomized controlled trials enrolling adults with neovascular age-related macular degeneration or diabetic macular edema treated with the ranibizumab Port Delivery System (100 mg/mL) versus monthly intravitreal ranibizumab 0.5 mg. This systematic review and meta-analysis was conducted according to a predefined PICOTT framework. Continuous and binary outcomes were pooled with mean differences (MDs) and risk ratios (RRs) with a 95% confidence interval (CI), respectively, with a random-effects model. Statistical analyses were performed using RevMan. RESULTS: Three trials were included, with a total of 1,149 eyes of which 688 (60%) received PDS and 461 (40%) received monthly ranibizumab. No significant differences were observed in BCVA (nAMD: MD - 0.69 letters; 95% CI - 2.52 to 1.14; = .46; DME: MD 0.20; 95% CI - 1.20 to 1.60; = .78) or CRT (nAMD: MD 26.67 µm; 95% CI - 16.55 to 69.88; = .23; DME: MD - 3.80; 95% CI - 17.20 to 9.60; = .58). Incidence of ocular AEs was significantly higher with PDS (RR 1.80; 95% CI 1.49-2.17; < .00001; I=74%). Among specific complications, conjunctival bleb or filtering bleb leak (RR 15.29; 95% CI 2.31-101.35; = .005), conjunctival erosion (RR 8.87; 95% CI 1.66-47.35; = .01), vitreous hemorrhage (RR 3.61; 95% CI 1.24-10.49; = .02), hyphema (RR 5.77; 95% CI 1.03-32.20; = .05), and conjunctival retraction (RR 5.78; 95% CI 1.04-32.29; = .05) occurred significantly more often with PDS. Systemic AEs were comparable between treatment arms (RR 1.00; 95% CI 0.89-1.13; = .98). CONCLUSION: In this systematic review and meta-analysis of three randomized controlled trials, PDS was associated with visual and anatomical results comparable to monthly ranibizumab in patients with nAMD. Evidence in DME was limited to a single trial, and conclusions in this population should be considered exploratory. PDS was associated with a higher incidence of procedure- and device-related ocular complications.

Ranibizumab Port Delivery System shows comparable visual and anatomical outcomes to monthly ranibizumab in nAMDPort Delivery System Shows Similar Results to Monthly Eye Injections

How this fits prior evidence

Study Details

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Ranibizumab Port Delivery System shows comparable visual and anatomical outcomes to monthly ranibizumab in nAMDPort Delivery System Shows Similar Results to Monthly Eye Injections

How this fits prior evidence

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