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A patient experienced temporary blindness after a coronary angiogram. Contrast agent toxicity affecting the occipital lobes was the suspected cause of this cortical blindness.

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Area of Science:

  • Ophthalmology
  • Neurology
  • Cardiology
  • Radiology

Background:

  • Coronary angiography (CAG) is a common procedure for diagnosing coronary artery disease.
  • Patients with pre-existing conditions like diabetes and hypertension may have increased risks.
  • Post-coronary artery bypass grafting (CABG) patients undergo regular cardiac evaluations.

Observation:

  • A 50-year-old male with diabetes, hypertension, and post-CABG status presented with sudden, complete vision loss.
  • Visual deficit occurred approximately one hour after undergoing coronary angiography.
  • Comprehensive ophthalmological, neurological, and brain MRI evaluations, including the occipital region, showed no abnormalities.

Findings:

  • The patient experienced a complete, yet temporary, loss of vision.
  • No specific etiology for the visual disturbance was definitively identified.
  • Cortical blindness, potentially due to contrast agent toxicity selectively affecting the occipital lobes, was hypothesized as the most probable mechanism.

Implications:

  • This case highlights a rare, transient adverse event following coronary angiography.
  • It underscores the importance of considering contrast-induced neurotoxicity, specifically cortical blindness, in the differential diagnosis of post-procedural visual disturbances.
  • Further research may be needed to elucidate the precise mechanisms and risk factors associated with contrast-induced cortical blindness in cardiovascular procedures.