PURPOSE: Leprechaunism is a rare congenital syndrome caused by mutations of the 
insulin receptor gene, transmitted in an autosomal recessive pattern. Insulin 
growth factor-1 (IGF-1) treatment can be a therapeutic option in this syndrome 
by its insulin-like effects. Nevertheless, it is of note that IGF-1 has also an 
angiogenic activity.
METHODS: Fundus examination by ophthalmoscopy, fluorangiography, and laser 
treatment were performed.
RESULTS: A 17-year-old girl with leprechaunism, under treatment with high doses 
of insulin, presented a florid diabetic retinopathy. The large 
neovascularization of the disk regressed after treatment with argon laser 
panretinal photocoagulation. Five years after treatment, the patient maintained 
good vision.
CONCLUSIONS: This clinical case is of interest for 2 reasons: 1) the large 
retinal neovascularization was likely due to the high insulin dosages; 2) this 
is the first case in which a sustained regression of retinal neovascularization 
has been observed after laser treatment in leprechaunism.