Abstract: Diabetic macular edema (DME) is the main cause of vision loss and even blindness in patients with diabetic retinopathy. Intravitreal anti-vascular endothelial factor therapy has become the gold standard management of DME. However, not all eyes response optimally to common management of DME, which could be due to the differences of individual factors. Increasing age could be the predictive factors for poor outcome. The influence of glycemic control, hypertension, dyslipidemia, chronic kidney disease and relative factors on treatment response require further investigation. Identifying the systemic factors that influence the treatment response of DME can provide the evidence to predict the prognosis of DME, and improve the efficacy of clinical treatment.