To conduct a pragmatic randomised equivalence trial to assess clinical- and cost-effectiveness, safety, participant experience and acceptability of Subthreshold Micropulse Laser (SML) applied after the Central Retinal Subfield Thickness (CRT) is <400μm following initial anti-VEGF injections, compared to continued anti-VEGF monotherapy, in people who originally presented with severe DMO (CRT ≥400μm). DAME incudes a nested process evaluation to assess post-trial implementation and scalability