Such calcification is a lesion not only of the nerve membranes, but also of its entire cross-section. Calcination is unilateral, with a spread to the unilateral half of the chiasm and the visual tract.
Meningiomas, and other tumors of the nerve membranes. The soft-tissue component is not present. There are no signs of contrast accumulation. There are no characteristic changes by the bones of the orbit, the inclined process, the optic nerve channel [5, 9]. Our clinical case isn’t a consequence of a nerve tumor, for example meningioma, since blindness developed at 3. At this age, the appearance of meningiomas is extremely unlikely, which is confirmed by the absence of sings of a nerve tumor on neuroimaging from 2014.
Endocrine diseases (hypoparathyroidism, hyperparathyroidism and other endocrinopathies). The patient has no clinical and laboratory signs of impaired calcium metabolism. The patient has a unilateral lesion [2, 3, 4, 5, 10].
Post-traumatic changes. Absence of anamnestic information showing injury. There are no typical post-traumatic changes by the eyeball. There are no calcifications in the eyeball and nerve area near the eyeball itself [6].
Metabolic diseases. The patient has no clinical and laboratory signs of metabolic disorders [3, 5, 8].
The clinical case presented for discussion is unusual for several reasons:
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No history of causes of vision loss in the left eye. There are no references to trauma, eye diseases, systemic diseases, endocrinopathy.
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There is no anamnestic data on the dynamics of vision loss.
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Discrepancy between clinical data and neuroimaging data: ossification of the entire optic nerve across the entire diameter, throughout the orbital part, in the optic canal, and the intracranial part of the nerve. Ossification extends to the unilateral half of the chiasm and the initial parts of the visual tract. Several contradictory points are noted. First, it doesn’t reduce the size of the eyeball compared to a healthy one. There were no signs of atrophic changes on his part. Second, there are no signs of atrophic changes in the initial parts of the optic nerve from the eyeball to calcification. Third, it spread calcification to the area of the chiasm and the unilateral optic nerve in the absence of sings of homonymous hemianopsia (syndrome of disfunction to half of the chiasm and the visual tract). (Fig. 3)