Minqing Zhang

Jianing Qiu, Jian Wu, Hao Wei et al.

We present VisionFM, a foundation model pre-trained with 3.4 million ophthalmic images from 560,457 individuals, covering a broad range of ophthalmic diseases, modalities, imaging devices, and demography. After pre-training, VisionFM provides a foundation to foster multiple ophthalmic artificial intelligence (AI) applications, such as disease screening and diagnosis, disease prognosis, subclassification of disease phenotype, and systemic biomarker and disease prediction, with each application enhanced with expert-level intelligence and accuracy. The generalist intelligence of VisionFM outperformed ophthalmologists with basic and intermediate levels in jointly diagnosing 12 common ophthalmic diseases. Evaluated on a new large-scale ophthalmic disease diagnosis benchmark database, as well as a new large-scale segmentation and detection benchmark database, VisionFM outperformed strong baseline deep neural networks. The ophthalmic image representations learned by VisionFM exhibited noteworthy explainability, and demonstrated strong generalizability to new ophthalmic modalities, disease spectrum, and imaging devices. As a foundation model, VisionFM has a large capacity to learn from diverse ophthalmic imaging data and disparate datasets. To be commensurate with this capacity, in addition to the real data used for pre-training, we also generated and leveraged synthetic ophthalmic imaging data. Experimental results revealed that synthetic data that passed visual Turing tests, can also enhance the representation learning capability of VisionFM, leading to substantial performance gains on downstream ophthalmic AI tasks. Beyond the ophthalmic AI applications developed, validated, and demonstrated in this work, substantial further applications can be achieved in an efficient and cost-effective manner using VisionFM as the foundation.

Hao Wei, Peilun Shi, Juzheng Miao et al.

Diabetic retinopathy (DR) is the most common diabetic complication, which usually leads to retinal damage, vision loss, and even blindness. A computer-aided DR grading system has a significant impact on helping ophthalmologists with rapid screening and diagnosis. Recent advances in fundus photography have precipitated the development of novel retinal imaging cameras and their subsequent implementation in clinical practice. However, most deep learning-based algorithms for DR grading demonstrate limited generalization across domains. This inferior performance stems from variance in imaging protocols and devices inducing domain shifts. We posit that declining model performance between domains arises from learning spurious correlations in the data. Incorporating do-operations from causality analysis into model architectures may mitigate this issue and improve generalizability. Specifically, a novel universal structural causal model (SCM) was proposed to analyze spurious correlations in fundus imaging. Building on this, a causality-inspired diabetic retinopathy grading framework named CauDR was developed to eliminate spurious correlations and achieve more generalizable DR diagnostics. Furthermore, existing datasets were reorganized into 4DR benchmark for DG scenario. Results demonstrate the effectiveness and the state-of-the-art (SOTA) performance of CauDR.

Hao Wei, Bowen Liu, Minqing Zhang et al.

Generalist foundation model has ushered in newfound capabilities in medical domain. However, the contradiction between the growing demand for high-quality annotated data with patient privacy continues to intensify. The utilization of medical artificial intelligence generated content (Med-AIGC) as an inexhaustible resource repository arises as a potential solution to address the aforementioned challenge. Here we harness 1 million open-source synthetic fundus images paired with natural language descriptions, to curate an ethical language-image foundation model for retina image analysis named VisionCLIP. VisionCLIP achieves competitive performance on three external datasets compared with the existing method pre-trained on real-world data in a zero-shot fashion. The employment of artificially synthetic images alongside corresponding textual data for training enables the medical foundation model to successfully assimilate knowledge of disease symptomatology, thereby circumventing potential breaches of patient confidentiality.

Hao Wei, Peilun Shi, Guitao Bai et al.

Ultra-wide optical coherence tomography angiography (UW-OCTA) is an emerging imaging technique that offers significant advantages over traditional OCTA by providing an exceptionally wide scanning range of up to 24 x 20 $mm^{2}$, covering both the anterior and posterior regions of the retina. However, the currently accessible UW-OCTA datasets suffer from limited comprehensive hierarchical information and corresponding disease annotations. To address this limitation, we have curated the pioneering M3OCTA dataset, which is the first multimodal (i.e., multilayer), multi-disease, and widest field-of-view UW-OCTA dataset. Furthermore, the effective utilization of multi-layer ultra-wide ocular vasculature information from UW-OCTA remains underdeveloped. To tackle this challenge, we propose the first cross-modal fusion framework that leverages multi-modal information for diagnosing multiple diseases. Through extensive experiments conducted on our openly available M3OCTA dataset, we demonstrate the effectiveness and superior performance of our method, both in fixed and varying modalities settings. The construction of the M3OCTA dataset, the first multimodal OCTA dataset encompassing multiple diseases, aims to advance research in the ophthalmic image analysis community.