Acute Visual Impairment in a Patient with Parkinson’s Disease after Successful Bilateral Subthalamic Nucleus Deep Brain Stimulation with Low-Dose Levodopa: A Case Report

Abstract

Background: Subthalamic nucleus deep brain stimulation (STN-DBS) is widely used for the treatment of primary motor symptoms in patients with Parkinson’s disease (PD). Further, recent evidence suggests that STN-DBS may relieve a few ophthalmic symptoms in PD, such as eye-blink rate and the flexibility of eye saccades. However, its exact effect on visual function remains unknown. Herein, we report the case of a patient with PD who underwent STN-DBS and experienced visual symptoms following levodopa reduction. Case presentation: A 63-year-old male patient with PD developed severe visual impairment after six months of high-frequency STN-DBS. His symptoms resolved after adjusting the levodopa dose prescribed to the patient. Conclusions: This case report suggests that DBS is beneficial in patients with PD in terms of eye-blink rate. However, the rapid reduction of medication after STN-DBS may lead to retinal atrophy and the shrinkage of vessel density in the ocular fundus. Thus, neurosurgeons should pay close attention to patients with visual symptoms when adjusting levodopa dosages.