A 48-year-old woman with poorly controlled type 2 diabetes (HbA1c 10.2%) presents with non-proliferative diabetic retinopathy (NPDR) and clinically significant diabetic macular edema (CSME). Fundoscopy shows hard exudates within 500 μm of the fovea and retinal thickening on OCT. She has not received any prior intravitreal treatment. What is the first-line pharmacological agent for this presentation?

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