Diabetic retinopathy (DR) is the 5th cause of blindness in the population of less than 50 years old in industrialized countries. Sample survey showed a lack of detection of DR and a discrepancy between the medical practices and the guidelines during the follow-up. Moreover the number of ophthalmologists is decreasing and the number of diabetics increasing. Faced with this public health problem, an organization for detecting the DR is in progress: non mydriatic digital camera are used by non medical technicians connected with reading centres. Diabetic macular edema (DME) is the most common cause of visual impairment. Recently, optical coherence tomography (OCT), a new imaging tool has showed the role of vitreous tractions in some DME. OCT provides clear diagnostic elements for vitrectomy indications. Very recently, vitrectomy proved to be favorable in DME with vitreous tractions.