Increased vitreous IGF-1 levels have been correlated with the severity of ischemia-associated diabetic retinal neovascularization.7–11 The action of IGF-1 may also depend on genetic factors and/or metabolic changes in the retinal epithelium affecting oxygenation, VEGF and P44/42 protein kinase activity. This evidence concerns the gene IGF1 and ischemia.