**16. Treatment plan**

Patients with DME at high risk for complications and vision loss require close monitoring at short intervals, intensive flexible treatment and arrangements for urgent visits and referrals. Very often, the patients present with multiple ophthalmic and systemic risk factors or develop them while they are under our care. Unrecognized and poorly treated complications and their exacerbations will readily explain the lack of results after "routine" management. Instead of labeling the patient as "non-responder" and giving up treatment altogether, or waiting for the inevitable vision deterioration in order to "start reacting", a "proactive" approach is more effective to achieve high and stable visual acuity, even in difficult patients.
