In March of 2019, Dr. Kokame was invited to the Retina World Congress, whose goal is to have an international sharing of knowledge from colleagues, speakers, and professors from around the world. The Retina World Congress’ inaugural meeting was in 2017. Specialists from all over the country and the world come to attend this one-of-a-kind retina congress. For this Retina World Congress, Dr. Kokame was invited to speak in the Controversies and Debates sessions on important current topics in retina. The topic of his debate was “What is the First Line of Treatment for Polypoidal Choroidal Vasculopathy (PCV)?” Dr. Kokame spoke first on combination therapy with Photodynamic therapy (PDT) and anti-VEGF therapy. He then pointed out that treatment has improved with better diagnostic studies, allowing an indocyanine green angiography demarcation of treatment for PDT. The use of concurrent anti-VEGF therapy counteracts the immediate increase in VEGF right after PDT. Dr. Kokame’s counter speech concentrated on anti-VEGF monotherapy alone for PCV. Based on the recent EVEREST II study, patients with PCV did better anatomically and visually with the use of combination therapy versus anti-VEGF monotherapy. Patients in this study gained additional vision improvement with more complete polyp resolution and had better control of disease activity. Additionally, patients received fewer number of treatments with PDT combined with anti-VEGF therapy compared to anti-VEGF therapy alone. Better vision with less treatment! Audience participation showed a strong preference to combined treatment for PCV.