This randomized study from the Fudan group, China, randomized patients with polypoidal choroidal vasculopathy (PCV)/ aneurysmal type 1 macular neovascularization (AT1), 1:1 to anti-VEGF agent (conbercept) injections with or without single fraction14 GyRBE PBT. A total of 45 eyes (86.5%) completed the 24-month follow-up. The mean gains in best-corrected visual acuity and the mean decrease in central retinal thickness were not significantly di9erent between the two groups. Combination therapy was superior to monotherapy for complete polypoidal lesion regression (80.0% vs. 48%, P = 0.03) and change in branching vascular network area (P < 0.01). The radiation-related microvascular abnormalities were observed in 55.0% of eyes. The authors concluded that proton (14 GyRBE) combined with anti-VEGF therapy could decrease the need for additional anti-VEGF injections for PCV/AT1. Proton beam irradiation can be a new strategy for the treatment of PCV/AT1. Longer follow-up is needed to fully evaluate the long-term safety.