Na Su

Ruiqi Wu, Na Su, Chenran Zhang et al.

Vision-language pretraining (VLP) has been investigated to generalize across diverse downstream tasks for fundus image analysis. Although recent methods showcase promising achievements, they significantly rely on large-scale private image-text data but pay less attention to the pretraining manner, which limits their further advancements. In this work, we introduce MM-Retinal V2, a high-quality image-text paired dataset comprising CFP, FFA, and OCT image modalities. Then, we propose a novel fundus vision-language pretraining model, namely KeepFIT V2, which is pretrained by integrating knowledge from the elite data spark into categorical public datasets. Specifically, a preliminary textual pretraining is adopted to equip the text encoder with primarily ophthalmic textual knowledge. Moreover, a hybrid image-text knowledge injection module is designed for knowledge transfer, which is essentially based on a combination of global semantic concepts from contrastive learning and local appearance details from generative learning. Extensive experiments across zero-shot, few-shot, and linear probing settings highlight the generalization and transferability of KeepFIT V2, delivering performance competitive to state-of-the-art fundus VLP models trained on large-scale private image-text datasets. Our dataset and model are publicly available via https://github.com/lxirich/MM-Retinal.

Xiao Ma, Zetian Zhang, Zexuan Ji et al.

Myopia is a manifestation of visual impairment caused by an excessively elongated eyeball. Image data is critical material for studying high myopia and pathological myopia. Measurements of spherical equivalent and axial length are the gold standards for identifying high myopia, but the available image data for matching them is scarce. In addition, the criteria for defining high myopia vary from study to study, and therefore the inclusion of samples in automated screening efforts requires an appropriate assessment of interpretability. In this work, we propose a model called adjustable robust transformer (ARTran) for high myopia screening of optical coherence tomography (OCT) data. Based on vision transformer, we propose anisotropic patch embedding (APE) to capture more discriminative features of high myopia. To make the model effective under variable screening conditions, we propose an adjustable class embedding (ACE) to replace the fixed class token, which changes the output to adapt to different conditions. Considering the confusion of the data at high myopia and low myopia threshold, we introduce the label noise learning strategy and propose a shifted subspace transition matrix (SST) to enhance the robustness of the model. Besides, combining the two structures proposed above, the model can provide evidence for uncertainty evaluation. The experimental results demonstrate the effectiveness and reliability of the proposed method. Code is available at: https://github.com/maxiao0234/ARTran.

Ruiqi Wu, Yuang Yao, Tengfei Ma et al.

Multimodal large language models (MLLMs) have recently demonstrated remarkable reasoning abilities with reinforcement learning paradigm. Although several multimodal reasoning models have been explored in the medical domain, most of them focus exclusively on basic reasoning, which refers to shallow inference based on visual feature matching. However, real-world clinical diagnosis extends beyond basic reasoning, demanding reasoning processes that integrate heterogeneous clinical information (such as chief complaints and medical history) with multimodal medical imaging data. To bridge this gap, we introduce MM-Retinal-Reason, the first ophthalmic multimodal dataset with the full spectrum of perception and reasoning. It encompasses both basic reasoning tasks and complex reasoning tasks, aiming to enhance visual-centric fundamental reasoning capabilities and emulate realistic clinical thinking patterns. Building upon MM-Retinal-Reason, we propose OphthaReason, the first ophthalmology-specific multimodal reasoning model with step-by-step reasoning traces. To enable flexible adaptation to both basic and complex reasoning tasks, we specifically design a novel method called Uncertainty-Aware Dynamic Thinking (UADT), which estimates sample-level uncertainty via entropy and dynamically modulates the model's exploration depth using a shaped advantage mechanism. Comprehensive experiments demonstrate that our model achieves state-of-the-art performance on both basic and complex reasoning tasks, outperforming general-purpose MLLMs, medical MLLMs, RL-based medical MLLMs, and ophthalmic MLLMs by at least 24.92\%, 15.00\%, 21.20\%, and 17.66\%. Project Page: \href{https://github.com/lxirich/OphthaReason}{link}.

Mingxiao Li, Fang Qu, Zhanpeng Chen et al.

While MLLMs perform well on perceptual tasks, they lack precise multimodal alignment, limiting performance. To address this challenge, we propose Vision Dynamic Embedding-Guided Pretraining (VDEP), a hybrid autoregressive training paradigm for MLLMs. Utilizing dynamic embeddings from the MLP following the visual encoder, this approach supervises image hidden states and integrates image tokens into autoregressive training. Existing MLLMs primarily focused on recovering information from textual inputs, often neglecting the effective processing of image data. In contrast, the key improvement of this work is the reinterpretation of multimodal alignment as a process of recovering information from input data, with particular emphasis on reconstructing detailed visual features.The proposed method seamlessly integrates into standard models without architectural changes. Experiments on 13 benchmarks show VDEP outperforms baselines, surpassing existing methods.