 Although anti-vascular endothelial growth factor VEGF therapy is generally effective as treatment for center-involved diabetic macular edema DME, a substantial proportion of anti-VEGF-treated eyes with DME do not achieve vision of 2020 or complete resolution of retinal thickening. Indeed, over 50 of ranibizumab-treated eyes did not achieve a 2 or more line improvement in visual acuity from baseline at 2 years in Protocol I, a previous DRCR.net Diabetic Retinopathy Clinical Research Network study. Furthermore, 27 of ranibizumab-treated eyes still had central subfield CSF thickness on time-domain optical coherence tomography OCT 300 at 1 year, and more than 40 of ranibizumab-treated eyes did not achieve complete resolution of retinal thickening 250 microns by 2 years. Thus, there is a need for alternative or additional treatments that will improve vision by reducing retinal edema in eyes with persistent DME following previous anti-VEGF therapy. Intravitreal steroid is not as efficacious as ranibizumab in eyes with DME overall, but it has been shown to have a positive effect for DME in some eyes and might add benefit in eyes that are already receiving anti-VEGF. 