Although the proper scan for sinus related issues is a CT, this finding is VERY common on brain MRIs. Many people have this and don't do a thing about it (except suffer through our sinus issues!).

Lesions are scars. Like scars, always there but it is possible to shrink in size so that they may be difficult to detect. Also, disease activity comes first and is what causes the lesions, which can take a long time to show up. Remission has nothing to do with lesions showing up or not but contrast will show if the lesions are active. I'm not a doctor but IMHO there doesn't appear to be anything MS-ey in the radiologist's report.

Re: Jacob's eye, it sounds like visiting a neuro-ophthalmologist might be a good idea.