Diabetic retinopathy is a leading cause of vision loss in adults. Current treatment options focus on late stage vascular abnormalities. However, early stage neuronal dysfunction has been identified using electroretinography (ERG) and might provide an opportunity for early detection and treatment. This talk will review data from diabetic animal models and humans that show delays in ERG oscillatory potentials in response to dim flash stimuli prior to vascular structure changes. Early detection of diabetic retinopathy opens a new treatment window. Neuroprotective approaches for diabetic retinopathy that slow the progression of vision loss will be discussed, such as dopamine treatments and physical exercise.