Retinal vascular diseases such as retinopathy of prematurity, diabetic retinopathy, and retinal vein occlusion, and other retinal vascular diseases, with abnormal proliferation of retinal neovascularization as the main pathological manifestation. Exosomes derived from bone marrow mesenchymal stem cells transmit biologically active molecules through paracrine action to mediate the exchange of materials and information between cells. Among them, miRNA and other contents play key roles in transmitting information to regulate the proliferation of endothelial cells, the formation of the lumen, and new blood vessels in an ischemic and hypoxic environment. And it can cross the blood-retinal barrier without causing immune and inflammatory reactions and has great potential in the treatment of ophthalmic diseases. This article summarizes the role and possible mechanism of miRNA in bone marrow mesenchymal stem cell-derived exosomes in retinal neovascularization, with a view to broadening new ideas for the application of exosomes in the diagnosis and treatment of ophthalmic diseases.