Background: Central retinal vein occlusion (CRVO) is a common retinal vascular disorder and a leading cause of visual loss. It is thought to arise from vascul ar obstruction at the level of the lamina cribrosa. The purpose of the study rep orted here was to evaluate the potential benefit of radial optic neurotomy (RON) and determine its effect on foveal thickness and macular volume in patients wit h CRVO. Methods: We conducted a prospective pilot study of ten patients with CRV O. Visual acuity (VA) score measured with the Early Treatment Diabetic Retinopat hy Study chart and the corresponding Snellen equivalent were assessed before and 6 months after surgery. Colour fundus photography, fluorescein angiography (FA) and optical coherence tomography (OCT) were carried out before and at 2, 6, 12 and 24 weeks after surgery. Foveal thickness and macular volumes were assessed u sing OCT. Results: Visible reperfusion was observed in four of the ten patients at the time of surgery. VA score improved in eight of the ten patients from a me dian score of 11.50 (range 0-68) to a median score of 35.00 (range 3-79). Macu lar volumes decreased in six of seven patients from a median of 4.99mm3(range 2. 68-6.77) to amedian of 3.11mm3 (range 1.11-5.02). Foveal thickness decreased i n six of seven patients from a median of 596.50 μm (range 338.50-745.50) to a median of 330.50 μm (range 118-634.50). Six of ten patients developed a chorio retinal venous anastomosis. Macular oedema on OCT persisted in six of ten patien ts. Conclusions: We observed an improvement in VA score and a corresponding redu ction in foveal thickness and macular volume following RON, but macular oedema p ersisted in 60%of patients. Whilst op timisation of patient selection criteria remains a challenge, this pilot study suggests that RON has a beneficial effect on VA in patients presenting with CRV O. Background: Central retinal vein occlusion (CRVO) is a common retinal vascular disorder and a leading cause of visual loss. It is thought to arise from vascul ar obstruction at the level of the lamina cribrosa. The purpose of the study rep orted here was to evaluate the potential benefit of radial optic neurotomy (RON) and determine its effect on foveal thickness and macular volume in patients wit h CRVO. Methods: We conducted a prospective pilot study of ten patients with CRV O. Visual acuity (VA) score measured with the Early Treatment Diabetic Retinopat hy Study chart and the corresponding Snellen equivalent were assessed before and 6 months after surgery. Color fundus photography, fluorescein angiography (FA) and optical coherence tomography (OCT) were carried out before and at 2, 6, 12 and 24 weeks after surgery. Foveal thickness and macular volumes were assessed u sing OCT. Results: Visible reperfusion was observed in four of the ten patients at the time of surgery. VA score imp roved in eight of the ten patients from a me dian score of 11.50 (range 0-68) to a median score of 35.00 (range 3-79). Macu lar volumes decreased in six of seven patients from a median of 4.99 mm 3 (range Foveal thickness decreased in six of seven patients from a median of 596.50 μm (range 338.50-745.50) to a median of 330.50 μm (range 118-634.50) Six of ten patients developed a chorio retinal venous anastomosis. Macular oedema on OCT persisted in six of ten patien ts. Conclusions: We observed an improvement in VA score and a corresponding redution in foveal thickness and macular volume following RON, but macular oedema Whilst opiates were selected in 60% of patients. Whilst optimization of patient selection criteria remains a challenge, this pilot study suggests that RON has a beneficial effect on VA in patients presenting with CRV O.