Diabetic macular edema (DME) is a major cause of visual impairment in patients with diabetes mellitus and it occurs as a result of the breakdown of the blood retinal barrier due to metabolic changes associated with hyperglycemia.1 The current treatment for DME targets vascular endothelial growth factor (VEGF), which has been identified as the most important factor in the pathogenesis of DME.2 However, while there is often a functional improvement after the resolution of DME with VEGF inhibition, ischemic changes may still result in irreversible vision loss in the absence of edema. This evidence concerns the gene VEGFA and diabetic macular edema.