Twenty six eyes of 22 diabetic patients with clinically significant macular edema were included in a retrospective study of the outcome of treatment without fundus fluorescein angiography during December 1994 to December 1995 at Siriraj Hospital. The results of one year follow up showed that macular lesions were improved in 20 eyes, worse in 6 eyes. Visual acuity was improved in 6 eyes, worse in 5 eyes and stabilized in 15 eyes. We suggest that in any circumstances when angiography is not available, Ophthalmologists may treat these patients by focal or grid treatment or combined treatment in first session.