One important arm in the pathogenesis of DME is the inflammatory component, Dexamethasone is strong anti-inflammatory and antiedema drug that is well-known to down regulate not only VEGF but also other inflammatory cytokines which may explain the proper response to IDI in cases of resistance to anti-VEGF agents, besides that it reduces leukocytosis and decreases vascular leakage. The gene discussed is VEGFA; the disease is Increased total leukocyte count.