For proliferative cases like such as in PDR or, uh, retinal vein occlusions, uh, how many anti-VEGF injections would you consider, uh, before proceeding with a vitrectomy?

Uh, certainly this is, uh, something that, uh, especially in the, uh, in diabetes, for example, uh, in the-- in proliferative diabetic retinopathy, we have good data from DRCR, uh, where, uh, they studied this exact question in terms of what is better to do.

Do we need to do, uh, which prompt vitrectomy versus, uh, uh, versus, uh, injections? And certainly we know that both groups are doing very, very well.

It's just, uh, then we have to dig into the prior ocular history.

Is this the first hemorrhage or is the number tenth hemorrhage? Does this patient have a history of, uh, years of injections? So this is all guides in terms of at least my personal decision-making, uh, in terms of what we should be offering.

But certainly I think initially, especially with in the context of a vitreous hemorrhage from R-RVO or, uh, or diabetes, I think especially in the acute setting, um, starting with an anti-VEGF at least one to two, um, this is certainly, um, this is a good choice.

I don't think that there is a timing.

And, um, what, what is your timeline in terms of somebody who might be completely healthy, their fundus, uh, is completely obscured, they don't have diabetes? Would you take those patients promptly or would you observe?