A study, reported in the journal of the American Academy of Ophthalmology (AAO), has suggested that cost-savings of almost 90% may be made when choosing between relatively equivalent treatment options for the management of diabetic macular edema (DME). Analysis of the main treatment options for DME, conducted by Dr. William Smiddy of the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, showed that symptoms at presentation may be a critical determinant in choosing alternative treatments, ultimately dictating the cost of care for individual patients. The core treatments for DME include focal laser, intravitreal triamcinolone acetonide (IVTA) and more recently, inhibitors of vascular endothelial growth factor (VEGF). Clinical trials with a number of anti-VEGF agents, including pegaptanib, bevacizumab, ranibizumab and aflibercept, suggest that efficacy gained through their use may be superior to focal laser and corticosteroid treatment.