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Veterinary ophthalmology.

Periodical
Ophthalmology
Veterinary Medicine
Eye Diseases
Publisher:
Blackwell Science,
Frequency: Six no. a year, 2004-
Country: England
Language: English
Author(s):
American College of Veterinary Ophthalmologists.
Start Year:1998 -
ISSN:
1463-5216 (Print)
1463-5224 (Electronic)
1463-5216 (Linking)
Impact Factor
1.6
2022
NLM ID:100887377
(OCoLC):41092864
LCCN:sn 99003713
Classification:W1 VE933T
Keratometry, biometry and prediction of intraocular lens power in the equine eye.
Veterinary ophthalmology    August 31, 2006   Volume 9, Issue 5 357-360 doi: 10.1111/j.1463-5224.2006.00493.x
McMullen RJ, Gilger BC.To determine ocular dimensions (A- and B-scan ultrasound) and corneal curvature (radius of corneal diameter determined in B-scan ultrasound) in the equine eye and to calculate the appropriate dioptric power for a posterior chamber intraocular lens (IOL) necessary to achieve emmetropia in the eyes of horses undergoing lens extraction. Methods: Fourteen clinically normal adult horses of various breeds. Additionally, for comparison, one American Miniature colt foal, and one 2.5-year-old Shire gelding were examined. Methods: B-scan ultrasound was performed on one eye from each horse. One eye from ...
Clinical features and outcomes of phacoemulsification in 39 horses: a retrospective study (1993-2003).
Veterinary ophthalmology    August 31, 2006   Volume 9, Issue 5 361-368 doi: 10.1111/j.1463-5224.2006.00494.x
Fife TM, Gemensky-Metzler AJ, Wilkie DA, Colitz CM, Bras ID, Klages DC.To identify visual outcome and postoperative complications following phacoemulsification of equine cataracts. Methods: Records of 39 horses (55 eyes) with cataracts were reviewed. Methods: Eyes with cataracts removed by phacoemulsification were included in the study. Data collected included age, breed, sex, stage and etiology of cataract, unilateral vs. bilateral involvement, and ultrasound findings. Horses were grouped by etiology of the cataract. Visual outcome and complications were evaluated for each group and the overall population. Results: Immediately postoperatively 46 out of 47 eyes (...
Scleral rupture in dogs, cats, and horses.
Veterinary ophthalmology    April 26, 2006   Volume 9, Issue 3 149-155 doi: 10.1111/j.1463-5224.2006.00455.x
Rampazzo A, Eule C, Speier S, Grest P, Spiess B.The aim of this retrospective study was to summarize the most frequent clinical signs, ultrasonographic, and histological findings accompanying scleral rupture as a result of blunt trauma in dogs, cats, and horses. ANIMALS STUDIED AND PROCEDURES: Thirty small animals and three horses diagnosed with scleral rupture resulting from blunt trauma. B-mode ultrasonography was performed on 20 animals. Histopathology was carried out on 18 enucleated globes. Results: In small animals, 80% presented hyphema, 60% subconjunctival hemorrhage, and 53% eyelid and conjunctival swelling. In horses, 100% present...
Calcification associated with the nasolacrimal system of a horse: case report and mineralogic composition.
Veterinary ophthalmology    April 26, 2006   Volume 9, Issue 3 187-190 doi: 10.1111/j.1463-5224.2006.00454.x
Cassotis NJ, Schiffman P.A 12-year-old Paso Fino mare was evaluated for a chronic nasal and ocular discharge. A calcification was identified eroding through the nasal mucosa of the middle meatus. Differential considerations for this mass included dacryolith, nasal calculus, or calcified tooth root abscess. Anatomical location and case history and progression supported a dacryolith. Following removal, the calculus was submitted for mineralogic analysis. The calculus was primarily carbonate hydroxylapatite (Ca10(PO4)3(CO3)3(OH)2) with a minor NaCl halite constituent. Dacryoliths, or nasolacrimal calculi, are an uncommon...
Ophthalmic examination findings of Thoroughbred racehorses in Australia.
Veterinary ophthalmology    February 25, 2006   Volume 9, Issue 2 95-100 doi: 10.1111/j.1463-5224.2006.00444.x
Hurn SD, Turner AG.To record the prevalence and document the types of eye disease in population of Thoroughbred racehorses in Victoria, Australia. Methods: Prospective study. Methods: Two hundred four Thoroughbred racehorses. Methods: All horses and both eyes were examined at four metropolitan and two country racing stable complexes. Ophthalmic exam was performed following dark adaptation with a transilluminator, biomicroscope, and direct ophthalmoscope. Intraocular pressures were measured when indicated. Both pupils were dilated with tropicamide when indicated. Results: One hundred eighty-two (89.2%) flat-racin...
Constant rate infusion for topical ocular delivery in horses: a pilot study.
Veterinary ophthalmology    January 18, 2006   Volume 9, Issue 1 1-5 doi: 10.1111/j.1463-5224.2005.00424.x
Myrna KE, Herring IP.To assess the efficacy and kinetics of a continuous infusion modality for topical ophthalmic drug delivery via subpalpebral lavage in horses. Methods: Five ophthalmically normal horses Methods: A constant-rate continuous delivery pump was used to apply 0.01% fluorescein solution to the eyes of five ophthalmically normal horses via subpalpebral lavage. Fluorescein was applied at a rate of 0.14 mL/h for 72 h. Tear samples were collected from the ventral conjunctival fornix at regular intervals via capillary tube and tear fluorescein concentrations were determined via spectral assay. Laboratory s...
Congenital stationary night blindness in a Thoroughbred and a Paso Fino.
Veterinary ophthalmology    December 20, 2005   Volume 8, Issue 6 415-419 doi: 10.1111/j.1463-5224.2005.00416.x
Nunnery C, Pickett JP, Zimmerman KL.This report documents congenital stationary night blindness (CSNB) in two non-Appaloosa horse breeds (Thoroughbred and Paso Fino). History of vision impairment since birth, normal ocular structures on ophthalmic examination, and electroretinographic findings were consistent with CSNB. In one horse (Thoroughbred), a 9-year follow-up was carried out. In the Paso Fino, severe vision impairment from birth to approximately 1 year of age in both dim and bright light situations led to humane euthanasia and histopathologic confirmation of the disorder.
Equine amniotic membrane transplantation for corneal ulceration and keratomalacia in three horses.
Veterinary ophthalmology    September 24, 2005   Volume 8, Issue 5 311-317 doi: 10.1111/j.1463-5224.2005.00405.x
Lassaline ME, Brooks DE, Ollivier FJ, Komaromy AM, Kallberg ME, Gelatt KN.Amniotic membrane has antifibrotic, anti-angiogenic and antiprotease properties. This retrospective study was designed to investigate the use of equine amniotic membrane transplants (AMT) at preserving vision, maintaining the structural integrity of the globe and maximizing cosmesis in equine eyes with corneal ulceration and severe keratomalacia. Methods: Equine amnion had previously been aseptically harvested from a 12-year-old Thoroughbred mare during an elective Cesarean section. Sections of amnion were stored at -80 degrees C and thawed as needed. Records of equine cases at the University ...
Ocular penetration of oral doxycycline in the horse.
Veterinary ophthalmology    September 24, 2005   Volume 8, Issue 5 331-335 doi: 10.1111/j.1463-5224.2005.00422.x
Gilmour MA, Clarke CR, Macallister CG, Dedeo JM, Caudell DL, Morton RJ, Pugh M.To investigate intraocular penetration of orally administered doxycycline in the normal equine eye and to compare intraocular and serum doxycycline concentrations. Procedures Six mares were administered doxycycline at 10 mg/kg every 12 h by nasogastric tube for 5 days. Blood, aqueous, and vitreous samples were collected on days 1 and 5. All samples were assayed for doxycycline concentrations. Aqueous and vitreous samples were also assayed for protein quantitation. Results: Doxycycline was rapidly absorbed after the first dose (T(max) value of 1.42 +/- 1.28 h); and elimination of doxycycline oc...
Immune-mediated keratitis in horses: 19 cases (1998-2004).
Veterinary ophthalmology    July 13, 2005   Volume 8, Issue 4 233-239 doi: 10.1111/j.1463-5224.2005.00393.x
Gilger BC, Michau TM, Salmon JH.The purpose of this study is to describe clinical and histologic findings, treatment, and outcome of horses with suspected immune-mediated keratitis (IMMK). Methods: Retrospective study. Methods: Nineteen horses that presented to NCSU-VTH from 1998 to 2004 with IMMK. Procedures Information retrieved from the medical records included signalment, duration of clinical signs, therapy prior to initial examination, ophthalmic abnormalities, diagnostics performed, therapy instituted, and long-term vision. Results: Nineteen horses (22 eyes) were diagnosed with IMMK. Three distinct clinical groups were...
Ocular parameters related to drug delivery in the canine and equine eye: aqueous and vitreous humor volume and scleral surface area and thickness.
Veterinary ophthalmology    July 13, 2005   Volume 8, Issue 4 265-269 doi: 10.1111/j.1463-5224.2005.00401.x
Gilger BC, Reeves KA, Salmon JH.To measure the ocular surface area, scleral thickness, and the aqueous and vitreous humor volumes in the canine and equine eye. Animals studied Fourteen canine and 16 equine cadaver eyes. Methods: Eyes were measured either fresh or following fixation in formalin. Ocular surface area was calculated using the fluid displacement method. Globes were hemisected and aqueous and vitreous humor were collected and quantitated. Scleral thickness was measured by digital caliper, by image projection, and by ultrasonic biomicroscopy (UBM). Results: Mean +/- standard deviation (SD) scleral surface areas in ...
Superficial keratectomy and cryosurgery as therapy for limbal neoplasms in 13 horses.
Veterinary ophthalmology    July 13, 2005   Volume 8, Issue 4 241-246 doi: 10.1111/j.1463-5224.2005.00395.x
Bosch G, Klein WR.To determine the usefulness and clinical outcome of a combined procedure of superficial keratectomy and cryosurgery as a treatment for limbal neoplasms in horses. Methods: Retrospective study. Methods: Thirteen horses with 14 limbal tumors. Methods: Medical records of all patients with limbal tumors, referred to the Department of Equine Sciences of Utrecht University between 1995 and 2002, were retrieved. Patient data were analyzed with respect to signalment, tumor surface area and histologic diagnosis. Surgery, performed under general anesthesia, included surgical debulking of the tumor follo...
Ectopic cilium in seven horses.
Veterinary ophthalmology    May 25, 2005   Volume 8, Issue 3 199-202 doi: 10.1111/j.1463-5224.2005.00369.x
Hurn S, Turner A, Mc Cowan C.Ectopic cilium was diagnosed by slit-lamp biomicroscopy and treated surgically by transconjunctival excision in seven adult horses. All cases presented with a common history of blepharospasm, ocular discharge and keratitis. Ophthalmic examination revealed a single translucent cilium in the upper eyelid palpebral conjunctiva, emerging approximately 5 mm from the eyelid margin. Corneal ulceration was not observed in any horse. Most horses responded well to transconjunctival surgical excision. There was recurrence of ectopic cilium 6 weeks postoperatively in one horse. Histopathologic examination...
Primary invasive ocular squamous cell carcinoma in a horse.
Veterinary ophthalmology    May 25, 2005   Volume 8, Issue 3 193-197 doi: 10.1111/j.1463-5224.2005.00358.x
Kaps S, Richter M, Philipp M, Bart M, Eule C, Spiess BM.A 12-year-old Haflinger gelding was presented to the veterinary medical teaching hospital of the University of Zurich with a light-pink raised mass on the temporal limbus and conjunctiva of the left eye. Squamous cell carcinoma was confirmed histologically after keratectomy and cryotherapy. Seven months later, a smooth pink, progressively enlarging mass was observed within the cornea of the left eye. Ultrasonographically, the mass was not only infiltrating the corneal stroma but seemed to protrude into the anterior chamber. The globe was surgically removed and submitted for pathology. A histol...
Tear urea nitrogen and creatinine levels in horse and their correlation with serum values.
Veterinary ophthalmology    May 25, 2005   Volume 8, Issue 3 207-209 doi: 10.1111/j.1463-5224.2005.00392.x
Zapata GL, Britos RM, Pintos ME, Dreizzen E, Lausada NB, Arauz S.The objective of this paper was to determine the physiological values of urea nitrogen and creatinine in tears, and to compare the results with those obtained from serum. Thirty healthy thoroughbred horses were included in the study. Tear fluid samples were obtained using a glass capillary tube placed in lower conjunctival cul-de-sac. Blood samples were taken from the jugular vein. Tear and serum urea nitrogen and creatinine levels were quantitatively analyzed by an enzymatic colorimetric method. Urea nitrogen values were 4.22+/-1.84 mmol/l in tears and 4.44+/-1.78 mmol/l in serum, whereas cre...
Effect of vaccination against leptospirosis on the frequency, days to recurrence and progression of disease in horses with equine recurrent uveitis.
Veterinary ophthalmology    May 25, 2005   Volume 8, Issue 3 171-179 doi: 10.1111/j.1463-5224.2005.00367.x
Rohrbach BW, Ward DA, Hendrix DV, Cawrse-Foss M, Moyers TD.To evaluate the effect of vaccination against leptospirosis on frequency and days to recurrence of uveitis and progression of disease in horses with equine recurrent uveitis (ERU). Methods: Forty-one horses with ERU. Methods: Horses were randomly assigned to experimental (vaccinated) or control groups. Vaccine containing six serovars of Leptospira or placebo was administered, an ophthalmic examination performed and blood samples drawn on days 0, 28, 180 and 365. Antibody titers were measured against each serovar. Recurrence of uveitis was verified by ophthalmic examination. Results of the init...
Limbal pseudotumor in a Cob Pony.
Veterinary ophthalmology    March 15, 2005   Volume 8, Issue 2 135-138 doi: 10.1111/j.1463-5224.2005.00350.x
Saroglu M, Aktas M, Olgun D, Arun SS.A tumor-like tissue mass of lateral-limbal site in the right eye of a 12-year-old Cob Pony mare was presented for surgical removal. The mass, covering the lateral limbus, bulbar conjunctiva and part of the cornea, was surgically removed, and the corneal defect repaired with a pedicle bulbar conjunctival graft. The mass was inflammatory in nature containing mononuclear cells. No recurrence or complication occurred at 6- and 12-month follow-up examination.
Bilateral nodular lymphocytic conjunctivitis in a horse.
Veterinary ophthalmology    March 15, 2005   Volume 8, Issue 2 129-134 doi: 10.1111/j.1463-5224.2005.00349.x
Stoppini R, Gilger BC, Malarkey DE, Ratto A, Brigati G.A Russian jumper horse presented because of an ocular perilimbal conjunctival mass and, on clinical examination, two bilateral conjunctival masses were found, of different size and conformation. Attempts at complete excision of the left eye mass and excisional biopsy of the right eye mass were performed. The left eye mass recurred rapidly, but resolved completely after topical corticosteroid therapy. The two lesions had similar histopathologic features, characterized by focal, chronic, primarily lymphocytic conjunctivitis with follicular lymphoid hyperplasia. Special histopathologic staining t...
Pigmented squamous cell carcinoma of the conjunctiva of a horse.
Veterinary ophthalmology    October 30, 2004   Volume 7, Issue 6 421-423 doi: 10.1111/j.1463-5224.2004.04040.x
McCowan C, Stanley RG.Abstract A heavily pigmented tumor was removed from the lateral, perilimbal, bulbar conjunctiva of a bay Thoroughbred horse. Excision was incomplete and the base of the tumor was lasered on the assumption that the tumor was a melanoma. No other ophthalmic lesions were seen. Histology showed the mass to be a pigmented squamous cell carcinoma (SCC). The prognosis and recommended treatment protocols are different for SCC and melanoma. This is, to the best of our knowledge, the first report of an ocular, pigmented SCC in the veterinary literature.
Profiles of matrix metalloproteinase activity in equine tear fluid during corneal healing in 10 horses with ulcerative keratitis.
Veterinary ophthalmology    October 30, 2004   Volume 7, Issue 6 397-405 doi: 10.1111/j.1463-5224.2004.04052.x
Ollivier FJ, Brooks DE, Van Setten GB, Schultz GS, Gelatt KN, Stevens GR, Blalock TD, Andrew SE, Komaromy AM, Lassaline ME, Kallberg ME, Cutler TJ.Levels of tear film matrix metalloproteinases (MMPs) activity are significantly elevated in horses with ulcerative keratitis and contribute to the excessive breakdown of stromal collagen. Changes in the amount of proteolytic activity in horse tear film during corneal healing and stromal remodeling have not yet been reported, but we hypothesize they should decrease. In the present study we analyzed serial tear fluid from horses with ulcerative keratitis to identify any changes in MMP activity during corneal healing and stromal remodeling. Methods: Samples of tear fluid were obtained from both e...
Effects of trimethoprim-sulfadiazine on tear production and the fluctuations of Schirmer tear test values in horses.
Veterinary ophthalmology    October 30, 2004   Volume 7, Issue 6 385-390 doi: 10.1111/j.1463-5224.2004.04037.x
Rothschild CM, Sellon DC, Bryan GM, Gay JM, Hines MT.The objectives of this study were to observe the effects of trimethoprim-sulfadiazine on equine tear production and to determine normal fluctuations in Schirmer tear test (STT) values in horses. A randomized, placebo-controlled, blinded clinical trial measuring STT values in 15 horses over an 8-week period was performed. The treatment group (eight horses) received 30 mg/kg trimethoprim-sulfadiazine orally once a day and the control group (seven horses) received placebo (flour) at the same time. All horses were housed outdoors throughout the study. Schirmer tear test values were measured at 0, ...
The use of porcine small intestinal submucosa for the repair of full-thickness corneal defects in dogs, cats and horses.
Veterinary ophthalmology    August 18, 2004   Volume 7, Issue 5 352-359 doi: 10.1111/j.1463-5224.2004.04055.x
Bussieres M, Krohne SG, Stiles J, Townsend WM.To evaluate the efficacy of using a porcine small intestinal submucosa (SIS) graft covered by a conjunctival flap for the surgical repair of full-thickness corneal wounds in dogs, cats and horses. Methods: All records dating from August 1999 to February 2003 from Purdue University Veterinary Teaching Hospital of patients that had undergone ophthalmic surgical procedures and received a SIS corneal graft for a full-thickness lesion were reviewed. Fifteen cases were identified including six dogs, two cats and seven horses. Requirements for inclusion in this study were that SIS was used as a corne...
Use of topical mitomycin C in myoplasty of the medial rectus muscle of rabbits.
Veterinary ophthalmology    August 18, 2004   Volume 7, Issue 5 335-342 doi: 10.1111/j.1463-5224.2004.04026.x
Mamede FV, Laus JL, Cabral VP, Vicenti FA, Barbieri-Neto J.To possibly reduce postoperative adhesions that occur after ocular myoplasties, we investigated the topical effects of 0.04% mitomycin C on the repaired areas of the medial rectus muscle using an equine renal capsule preserved in 98% glycerin for reinforcement of the sutures. Twenty-four rabbits, divided into two groups of 12 animals each [untreated (control) and treated group (MMC)], were submitted to surgical rupture of the medial rectus muscle of one eye and repair of the defect 24 h later with sutures and an equine renal capsule. Post-operative prophylactic treatment of the two groups cons...
The use of semiconductor diode laser for deflation and coagulation of anterior uveal cysts in dogs, cats and horses: a report of 20 cases.
Veterinary ophthalmology    August 18, 2004   Volume 7, Issue 5 360-368 doi: 10.1111/j.1463-5224.2004.04004.x
Gemensky-Metzler AJ, Wilkie DA, Cook CS.To describe semiconductor diode laser use for anterior uveal cyst deflation and coagulation in dogs, horses and cats. Methods: The presenting clinical signs, surgical technique and postoperative results for four dogs, nine horses and seven cats with anterior uveal cysts treated with diode laser are described. Treated cysts were of sufficient size and/or number to potentially impair vision, damage the corneal endothelium, or increase intraocular pressure (IOP). One dog with free-floating cysts exhibited 'fly biting' behavior. Cysts were suspected of causing shying on the affected side and/or he...
Periocular sarcoid in a horse.
Veterinary ophthalmology    April 20, 2004   Volume 7, Issue 3 141-146 doi: 10.1111/j.1463-5224.2004.04027.x
Komáromy AM, Andrew SE, Brooks DE, Detrisac CJ, Gelatt KN.A periocular nodular sarcoid of the right upper and lower eyelids was diagnosed in an 11-year-old Thoroughbred mare. Computed tomography scan revealed the extent of the tumor. The mass was surgically debulked under general anesthesia, and the affected periocular region was injected intralesionally with Bacillus of Calmette and Guerin (BCG). An emulsion of cell wall fractions was used, which has been modified to reduce the toxic and allergic effect, but retain the antitumor activity. In total, five injections were performed at 2-week intervals. At follow-up 7 months after the last BCG injection...
Diagnostic ultrasonography of equine lens and posterior segment abnormalities.
Veterinary ophthalmology    February 26, 2004   Volume 7, Issue 2 127-139 doi: 10.1111/j.1463-5224.2004.04009.x
Scotty NC, Cutler TJ, Brooks DE, Ferrell E.To define the indications for equine ocular ultrasonography and to provide representative ultrasonographic images of lens and posterior segment diseases. Methods: Retrospective study. Equine medical records dating from January 1983 to March 2001 were reviewed. All cases that: (1) had a lens and/or posterior segment abnormality; and (2) received a complete ophthalmic examination and ocular ultrasonography were included. Results: Forty-three cases (n = 64 eyes) out of 112 total cases of equine lens and/or posterior segment abnormalities qualified. The following conditions were identified ultraso...
Changes in antibiotic resistance in equine bacterial ulcerative keratitis (1991-2000): 65 horses.
Veterinary ophthalmology    December 3, 2003   Volume 6, Issue 4 309-313 doi: 10.1111/j.1463-5224.2003.00312.x
Sauer P, Andrew SE, Lassaline M, Gelatt KN, Denis HM.To document changes in antibiotic resistance of organisms in cases of equine bacterial ulcerative keratitis over a 10-year time period. Methods: A retrospective study. Methods: Medical records of equine patients with bacterial ulcerative keratitis seen at the University of Florida's VMTH for the years 1991-2000 were reviewed. Methods: All cases of equine bacterial ulcerative keratitis for the above mentioned years were examined. Bacterial isolates were identified and subjected to Kirby-Bauer disc diffusion method sensitivity tests. Antibiotics used in the sensitivity tests included bacitracin,...
The effect of topical administration of atropine sulfate on the normal equine pupil: influence of age, breed and gender.
Veterinary ophthalmology    December 3, 2003   Volume 6, Issue 4 329-332 doi: 10.1111/j.1463-5224.2003.00315.x
Davis JL, Stewart T, Brazik E, Gilger BC.The purpose of this study was to determine the influence of age, breed and gender on vertical pupil diameter (VPD) following a single dose of 1% atropine sulfate ophthalmic solution in the normal equine eye. Methods: Thirty-two horses of various ages, breeds and genders were included. The horses had no history or clinical signs of ophthalmic disease. All horses studied had darkly pigmented irides. Methods: Two milligrams of 1% atropine sulfate ophthalmic solution was topically administered as a single dose in the right eye of each horse on Day 0. The VPD (mm) was measured in both eyes using di...
Superficial, nonhealing corneal ulcers in horses: 23 cases (1989-2003).
Veterinary ophthalmology    December 3, 2003   Volume 6, Issue 4 291-297 doi: 10.1111/j.1463-5224.2003.00309.x
Michau TM, Schwabenton B, Davidson MG, Gilger BC.To characterize superficial, nonhealing corneal ulcers in the horse and to assess the affect of age, breed, sex, inciting cause of the ulcer, and treatment on healing time of these ulcers. Methods: Retrospective study. Methods: Twenty-three horses with superficial, nonhealing corneal ulcerations. Methods: Medical records from 1989 to 2003 of horses diagnosed with superficial, nonhealing corneal ulcers were reviewed. Signalment, duration of clinical signs, ophthalmic abnormalities, treatment and response to treatment were recorded. Horses were treated, in addition to medical therapy, using debr...
Intravascular papillary endothelial hyperplasia of the conjunctiva in a horse.
Veterinary ophthalmology    September 3, 2003   Volume 6, Issue 3 269-272 doi: 10.1046/j.1463-5224.2003.00298.x
Herrera HD, Duchene AG, Croxatto JO, Burgués N, Amusquibar H.Vascular tumors of the conjunctiva in the horse are rare. We present a unique case of an intravascular papillary endothelial hyperplasia of the conjunctiva. Methods: Horse. Methods: Case report. A 6-year-old-mare presented with a red mass in the conjunctiva of the left eye. After complete ophthalmologic examination the lesion was excised. The tissue was processed for light microscopy and studied histopathologically. Results: Pathologic examination revealed a nonencapsulated vascular lesion composed of confluent vascular spaces filled by multiple papillary structures composed of a central colla...