The investigators have chosen to look at Macugen [TM] because of its specificity and generally good safety profile which has now been validated over >4 years. It is possible that a non-selective VEGF inhibitor that blocks all VEGF isoforms could be more deleterious to retinal function over the long term than a more selective VEGF antagonist that could spare several of the smaller soluble VEGF isoforms within the eye. [19] No increased risk of serious systemic adverse events has been shown in any of the major clinical trials of Macugen [TM]. [11] The incidence of ocular adverse events when used for treating AMD is low [20]. As discussed above, Macugen [TM] has been used with benefit in exudative DME but its effectiveness in ischaemic DME, for which there is currently no available treatment, remains unknown.