Treatment to prevent or reverse DME remains a major unmet clinical need. While several treatment options are available, they are associated with various risks and not all patients respond fully to the current treatment approaches.

For over 25 years, first-line therapy has been laser-induced retinal photocoagulation, which slows or reverses progression of the disease and can reduce visual loss.  However, the laser destroys areas of retina in the macula and only approximately half of patients respond.  Vitrectomy involves surgical removal of some or all of the vitreous from the eye and has been reported to have some potential benefit but it is invasive with associated surgical risks.

Inhibition of VEGF pathways has been an area of intense recent interest.  Although intravitreal VEGF inhibitors have shown clear benefit in clinical trials through reducing macular edema and increasing visual acuity, a significant number of DME patients do not respond fully to VEGF treatment.

Plasma kallikrein inhibition targets a VEGF-independent pathway and therefore has the potential to add to the treatment options for sufferers of DME including those that are non-responsive to VEGF inhibitors.

Prevention of DME has focused on improving blood sugar, blood pressure and blood lipid control. These measures have been shown to have a significant impact on DME onset, progression and visual outcome.