Background: There are a lot of potential benefits and drawbacks of optical coherence tomography angiography (OCTA), one of the most useful retinal imaging procedures, which may detect and diagnose a variety of diseases affecting the retina's blood vessels and optic nerve. Objective: To reveal the effect of central retinal vein occlusion on the vascular density of the optic nerve head using (OCTA) aiming at better understanding the pathophysiology of vein occlusion and providing a guide for management. Subjects and methods: Our study was carried out as an observational, case control study, 33 subjects who underwent OCTA at Suez Canal University Hospital, Ismailia, Egypt, were included and were divided according to OCTA findings into 3 groups; ischemic central retinal vein occlusion (CRVO) patients group consisted of 11 patients, non-ischemic CRVO patients group consisted of 11 patients and normal group consisted of 11 subjects. Results: Area under the curve = 1.000, sensitivity = 100%, and specificity = 100% were the results of a very effective discriminative capacity of RPC vessel density in the upper and lower quadrants to distinguish between ischemic and non-ischemic CRVO. Area under the curve = 0.979, sensitivity = 90.9%, and specificity = 100% were achieved when the RPC vessel density cutoff value in the nasal quadrant was 37. This significantly distinguished between ischemic and non-ischemic CRVO. Additionally, the ROC curve showed that macular thickness could not successfully distinguish between ischemic and non-ischemic CRVO. Conclusion: Early accurate diagnosis of central retinal vein occlusion (CRVO) must be the major goal of the ophthalmologist while facing these cases from the first second to avoid the probable dangerous sequences.