Diabetic retinopathy(DR), one of the common complications of diabetes, is a major cause of blindness. Traditionally, DR has been considered primarily a microvascular disease, and as research has progressed, it is now believed that disruption of the neuro-glia-vascular unit(NVU)and imbalance in its coupling mechanisms(coupling)play a key role in the early onset of DR. Understanding the cellular and molecular basis of NVU and how diabetes alters normal cellular communication and disrupts the cellular environment is important for the early prevention and treatment of DR. This paper summarizes the retinal NVU and its involvement in the molecular mechanism of DR pathogenesis, DR treatment based on retinal NVU repair, and discusses the future prospects and problems of DR.