Contrast Medium-Induced Transient Cortical Blindness: a Systematic Review of the Literature

Transient cortical blindness (TCB) is characterized by a partial or complete loss of perceived vision, normal fundi, normal pupillary reflexes, and unaltered extraocular movements. It is a rare complication of contrast medium use, with no definitive pathophysiology. This systematic review aimed to summarize identified risk factors, the most common clinical presentations, radiological and neurophysiological features and proposed pathophysiological mechanisms of TCB. A total of 115 patients, from 2 retrospective cohort studies, 10 case series, and 52 case reports, were included. The available evidence suggests that TCB can manifest after both invasive and non-invasive angiographic procedures. Higher contrast medium dosage and its injection solely into the posterior circulation are the only risk factors identified in association with TCB.