Nazlee Zebardast

Min Shi, Anagha Lokhande, Mojtaba S. Fazli et al. · harvard, stanford

Ophthalmic images and derivatives such as the retinal nerve fiber layer (RNFL) thickness map are crucial for detecting and monitoring ophthalmic diseases (e.g., glaucoma). For computer-aided diagnosis of eye diseases, the key technique is to automatically extract meaningful features from ophthalmic images that can reveal the biomarkers (e.g., RNFL thinning patterns) linked to functional vision loss. However, representation learning from ophthalmic images that links structural retinal damage with human vision loss is non-trivial mostly due to large anatomical variations between patients. The task becomes even more challenging in the presence of image artifacts, which are common due to issues with image acquisition and automated segmentation. In this paper, we propose an artifact-tolerant unsupervised learning framework termed EyeLearn for learning representations of ophthalmic images. EyeLearn has an artifact correction module to learn representations that can best predict artifact-free ophthalmic images. In addition, EyeLearn adopts a clustering-guided contrastive learning strategy to explicitly capture the intra- and inter-image affinities. During training, images are dynamically organized in clusters to form contrastive samples in which images in the same or different clusters are encouraged to learn similar or dissimilar representations, respectively. To evaluate EyeLearn, we use the learned representations for visual field prediction and glaucoma detection using a real-world ophthalmic image dataset of glaucoma patients. Extensive experiments and comparisons with state-of-the-art methods verified the effectiveness of EyeLearn for learning optimal feature representations from ophthalmic images.

Yan Luo, Yu Tian, Min Shi et al.

Fairness (also known as equity interchangeably) in machine learning is important for societal well-being, but limited public datasets hinder its progress. Currently, no dedicated public medical datasets with imaging data for fairness learning are available, though minority groups suffer from more health issues. To address this gap, we introduce Harvard Glaucoma Fairness (Harvard-GF), a retinal nerve disease dataset with both 2D and 3D imaging data and balanced racial groups for glaucoma detection. Glaucoma is the leading cause of irreversible blindness globally with Blacks having doubled glaucoma prevalence than other races. We also propose a fair identity normalization (FIN) approach to equalize the feature importance between different identity groups. Our FIN approach is compared with various the-state-of-the-art fairness learning methods with superior performance in the racial, gender, and ethnicity fairness tasks with 2D and 3D imaging data, which demonstrate the utilities of our dataset Harvard-GF for fairness learning. To facilitate fairness comparisons between different models, we propose an equity-scaled performance measure, which can be flexibly used to compare all kinds of performance metrics in the context of fairness. The dataset and code are publicly accessible via \url{https://ophai.hms.harvard.edu/datasets/harvard-glaucoma-fairness-3300-samples/}.

Mohammad Eslami, Solale Tabarestani, Ehsan Adeli et al.

With the advent of sophisticated machine learning (ML) techniques and the promising results they yield, especially in medical applications, where they have been investigated for different tasks to enhance the decision-making process. Since visualization is such an effective tool for human comprehension, memorization, and judgment, we have presented a first-of-its-kind estimation approach we refer to as Visualized Learning for Machine Learning (VL4ML) that not only can serve to assist physicians and clinicians in making reasoned medical decisions, but it also allows to appreciate the uncertainty visualization, which could raise incertitude in making the appropriate classification or prediction. For the proof of concept, and to demonstrate the generalized nature of this visualized estimation approach, five different case studies are examined for different types of tasks including classification, regression, and longitudinal prediction. A survey analysis with more than 100 individuals is also conducted to assess users' feedback on this visualized estimation method. The experiments and the survey demonstrate the practical merits of the VL4ML that include: (1) appreciating visually clinical/medical estimations; (2) getting closer to the patients' preferences; (3) improving doctor-patient communication, and (4) visualizing the uncertainty introduced through the black box effect of the deployed ML algorithm. All the source codes are shared via a GitHub repository.

Mohammad Eslami, Dhanvinkumar Ganeshkumar, Saber Kazeminasab et al.

We present CataractSAM-2, a domain-adapted extension of Meta's Segment Anything Model 2, designed for real-time semantic segmentation of cataract ophthalmic surgery videos with high accuracy. Positioned at the intersection of computer vision and medical robotics, CataractSAM-2 enables precise intraoperative perception crucial for robotic-assisted and computer-guided surgical systems. Furthermore, to alleviate the burden of manual labeling, we introduce an interactive annotation framework that combines sparse prompts with video-based mask propagation. This tool significantly reduces annotation time and facilitates the scalable creation of high-quality ground-truth masks, accelerating dataset development for ocular anterior segment surgeries. We also demonstrate the model's strong zero-shot generalization to glaucoma trabeculectomy procedures, confirming its cross-procedural utility and potential for broader surgical applications. The trained model and annotation toolkit are released as open-source resources, establishing CataractSAM-2 as a foundation for expanding anterior ophthalmic surgical datasets and advancing real-time AI-driven solutions in medical robotics, as well as surgical video understanding.

Liyin Chen, Nazlee Zebardast, Mengyu Wang et al.

Quantitative prediction of future retinal appearance from longitudinal imaging would support clinical decisions in progressive macular disease that currently rely on qualitative comparison or scalar progression scores. Recent methods have moved toward increasing generative complexity, but whether this complexity is necessary for slowly progressing retinal disease is unclear. We tested this through a controlled comparison of five conditioning configurations sharing one architecture and training dataset, spanning standard conditional diffusion, inference-aligned stochastic training, and deterministic regression. In our evaluation, aligning the training and inference input distributions produced large gains (delta-SSIM +0.082, SSIM +0.086, both p < 0.001), while the choice among aligned frameworks did not significantly affect any primary metric. Task-entropy and posterior-concentration analyses, replicated on two fundus autofluorescence (FAF) platforms, provided a mechanistic account: the predictable component of inter-visit change is small relative to time-invariant acquisition variability, leaving stochastic sampling with little width to exploit. Guided by these findings, we developed TRU (Temporal Retinal U-Net), a deterministic direct-regression model with continuous time-delta conditioning and multi-scale history aggregation. We evaluated TRU on 28,902 eyes across three imaging platforms: a mixed-disease Optos FAF cohort (9,942 eyes), zero-shot transfer to Stargardt macular dystrophy on Optos (288 eyes) and Heidelberg Spectralis (125 eyes), and a boundary evaluation on Cirrus en-face fundus images from a glaucoma cohort (18,547 eyes). TRU matched or exceeded delta-SSIM, SSIM, and PSNR in every FAF cohort against three state-of-the-art benchmarks, and its advantage grew monotonically with available history length.