michael kors handbags outlet A direct bedside visualization of the retina and optic nerve was first achieved in 1851 following the introduction of the handheld ophthalmoscope by Helmholtz.30 Over a century later, in 1974, Fris and Hoyt reported for the first time a subjective analysis of thinning of the retinal nerve fiber layer (RNFL; which is principally composed of axons from ganglion cell neurons) in patients with MS, as evaluated with handheld ophthalmoscopy.31 This observation was corroborated in 1994 in a postmortem study that demonstrated atrophy of the RNFL in 35 out of 49 eyes of patients with MS.32 Nevertheless, this study was not sufficiently quantitative to enable a full appreciation of the relationship between vision, RNFL thickness, and the integrity of the approximately 1.2 million axons that make up the optic nerve.
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