Idiopathic dural optic nerve sheath calcification

Idiopathic Dural Optic Nerve Sheath Calcification Associated with Sclerochoroidal Calcification: Case Report and Review of Literatures

We present a patient with idiopathic intracranial calcifications with simultaneous involvement of sclera, choroid, optic nerve, and trochlear apparatus. A 70-year-old woman with bilateral decreased vision was referred to our hospital. Ocular examinations revealed sclerochoroidal mass beneath superotemporal vascular arcade in macular area. Orbital CT scan shows bilateral calcification of dural optic nerve sheath and posterior wall of the globe as well as calcification in the trochlear apparatus and brain. Ultrasound showed highly reflective echogenic lesion with shadowing. OCT revealed rolling topography with thinning of the overlying choroid and outer nuclear layer as well as absence of the external limiting membrane and inner segment-outer segment junction. Slight irregular thickening of the retinal pigment epithelium is present. It is the first case of simultaneous bilateral dural optic nerve sheath and sclerochoroidal calcification.

Pathological Mineralization: The Potential of Mineralomics

Pathological mineralization has been reported countless times in the literature and is a well-known phenomenon in the medical field for its connections to a wide range of diseases, including cancer, cardiovascular, and neurodegenerative diseases. The minerals involved in calcification, however, have not been directly studied as extensively as the organic components of each of the pathologies. These have been studied in isolation and, for most of them, physicochemical properties are hitherto not fully known. In a parallel development, materials science methods such as electron microscopy, spectroscopy, thermal analysis, and others have been used in biology mainly for the study of hard tissues and biomaterials and have only recently been incorporated in the study of other biological systems. This review connects a range of soft tissue diseases, including breast cancer, age-related macular degeneration, aortic valve stenosis, kidney stone diseases, and Fahr’s syndrome, all of which have been associated with mineralization processes. Furthermore, it describes how physicochemical material characterization methods have been used to provide new information on such pathologies. Here, we focus on diseases that are associated with calcium-composed minerals to discuss how understanding the properties of these minerals can provide new insights on their origins, considering that different conditions and biological features are required for each type of mineral to be formed. We show that mineralomics, or the study of the properties and roles of minerals, can provide information which will help to improve prevention methods against pathological mineral build-up, which in the cases of most of the diseases mentioned in this review, will ultimately lead to new prevention or treatment methods for the diseases. Importantly, this review aims to highlight that chemical composition alone cannot fully support conclusions drawn on the nature of these minerals.

Idiopathic dural optic nerve sheath calcification associated with choroidal osteoma

A 28-year-old woman presented with a choroidal osteoma in the right eye and optic atrophy in the left eye, associated with bilateral optic nerve sheath calcification and calcifications in the pineal, choroid plexus, and dura (falx and tentorium). Visual acuity, tumor size, and intracranial calcifications did not change over 16 years. The combination of bilateral optic nerve sheath calcification with multiple intracranial calcifications suggests an unexplained and generalized dural calcification process. To the authors' knowledge, this is the first case of choroidal ossifying tumor associated with calcified lesions of the optic nerves. Although the pathogenesis of bone formation in choroidal osteoma remains uncertain, intraocular inflammation might be one cause.