The conundrum of transient cortical blindness following coronary angiography

We report a case of transient cortical blindness that occurred after coronary angiography and angioplasty performed through the right radial artery. This is a very rare entity, the physiopathology of which remains largely speculative. The most likely mechanism appears to be the local disruption of the blood-brain barrier by the contrast agent, possibly favoured by predisposing factors, which may cause a direct neurotoxic effect. All contrast agents can be associated with this complication, which does not seem to be volume dependent. The outcome is generally favourable, with spontaneous return of sight within 24-48 h and no requirement for specific therapy. Recurrence has never been reported.