Wykoff CC, et al. – This article was written with the objective to assess the effectiveness and safety of individualised 2.0 mg intravitreal aflibercept retreatment for diabetic macular oedema (DME) through the fifth year of management. The requirement for aflibercept retreatment was substantially decreased in the fourth and fifth years of aflibercept dosing for DME following initiation of therapy in the VISTA DME trial. While vision gains achieved amid the 3–year VISTA DME trial were maintained through ENDURANCE with a decreased treatment burden, clinically relevant worsening of diabetic retinopathy was seen with progression to PDR in 10% of the eyes.