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To the Editor: The ONTT has identified the presence of one or more brain MRI lesions at the time of optic neuritis as the single most important predictor of the development of CDMS at 5 years.1 The cumulative probability of CDMS at 5 years was 16% without brain MRI lesion, 37% for one to two MRI lesions, and 51% for three or more MRI lesions. Examination of the probability curves (figure 2 in reference 1), which combined the outcomes of the placebo (natural history), prednisone, and IV SoluMedrol groups, suggests a high rate of conversion to CDMS within the first year, followed by an apparent linear increase in MS conversion for patients with no, one to …
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