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My coauthors and I thank Dr Gotkine for his relevant comments regarding the long-term results of the ONTT. We agree that these findings will better assist clinicians in providing additional prognostic information for those presenting with an initial episode of optic neuritis.
The ONTT, which has captured more than 15 years of follow-up data on patients presenting with acute optic neuritis, occurred during a time when the serologic test for the NMO-IgG antibody was not available. The trial did not capture subsequent evaluations with spinal cord imaging, so we did not have good tools to track which patients might have had or developed either serological or imaging evidence of potential NMO.
Smith CH. Neuromyelitis Optica and the Optic Neuritis Treatment Trial—Reply. Arch Neurol. 2008;65(11):1546. doi:10.1001/archneur.65.11.1546-a