Zhihao Zhao

Junjie Yang, Zhihao Zhao, Siyuan Shen et al.

Robotic ophthalmic surgery is an emerging technology to facilitate high-precision interventions such as retina penetration in subretinal injection and removal of floating tissues in retinal detachment depending on the input imaging modalities such as microscopy and intraoperative OCT (iOCT). Although iOCT is explored to locate the needle tip within its range-limited ROI, it is still difficult to coordinate iOCT's motion with the needle, especially at the initial target-approaching stage. Meanwhile, due to 2D perspective projection and thus the loss of depth information, current image-based methods cannot effectively estimate the needle tip's trajectory towards both retinal and floating targets. To address this limitation, we propose to use the shadow positions of the target and the instrument tip to estimate their relative depth position and accordingly optimize the instrument tip's insertion trajectory until the tip approaches targets within iOCT's scanning area. Our method succeeds target approaching on a retina model, and achieves an average depth error of 0.0127 mm and 0.3473 mm for floating and retinal targets respectively in the surgical simulator without damaging the retina.

Zhihao Zhao, Yinzheng Zhao, Junjie Yang et al.

AI-based vascular segmentation is becoming increasingly common in enhancing the screening and treatment of ophthalmic diseases. Deep learning structures based on U-Net have achieved relatively good performance in vascular segmentation. However, small blood vessels and capillaries tend to be lost during segmentation when passed through the traditional U-Net downsampling module. To address this gap, this paper proposes a novel Kalman filter based Linear Deformable Diffusion (KLDD) model for retinal vessel segmentation. Our model employs a diffusion process that iteratively refines the segmentation, leveraging the flexible receptive fields of deformable convolutions in feature extraction modules to adapt to the detailed tubular vascular structures. More specifically, we first employ a feature extractor with linear deformable convolution to capture vascular structure information form the input images. To better optimize the coordinate positions of deformable convolution, we employ the Kalman filter to enhance the perception of vascular structures in linear deformable convolution. Subsequently, the features of the vascular structures extracted are utilized as a conditioning element within a diffusion model by the Cross-Attention Aggregation module (CAAM) and the Channel-wise Soft Attention module (CSAM). These aggregations are designed to enhance the diffusion model's capability to generate vascular structures. Experiments are evaluated on retinal fundus image datasets (DRIVE, CHASE_DB1) as well as the 3mm and 6mm of the OCTA-500 dataset, and the results show that the diffusion model proposed in this paper outperforms other methods.

Yinzheng Zhao, Zhihao Zhao, Junjie Yang et al.

Purpose: To investigate the changes in retinal vascular structures associated various stages of myopia by designing automated software based on an artif intelligencemodel. Methods: The study involved 1324 pediatric participants from the National Childr Medical Center in China, and 2366 high-quality retinal images and correspon refractive parameters were obtained and analyzed. Spherical equivalent refrac(SER) degree was calculated. We proposed a data analysis model based c combination of the Convolutional Neural Networks (CNN) model and the atter module to classify images, segment vascular structures, and measure vasc parameters, such as main angle (MA), branching angle (BA), bifurcation edge al(BEA) and bifurcation edge coefficient (BEC). One-way ANOVA compared param measurements betweenthenormalfundus,lowmyopia,moderate myopia,and high myopia group. Results: There were 279 (12.38%) images in normal group and 384 (16.23%) images in the high myopia group. Compared normal fundus, the MA of fundus vessels in different myopic refractive groups significantly reduced (P = 0.006, P = 0.004, P = 0.019, respectively), and performance of the venous system was particularly obvious (P<0.001). At the sa time, the BEC decreased disproportionately (P<0.001). Further analysis of fundus vascular parameters at different degrees of myopia showed that there were also significant differences in BA and branching coefficient (BC). The arterial BA value of the fundus vessel in the high myopia group was lower than that of other groups (P : 0.032, 95% confidence interval [Ci], 0.22-4.86), while the venous BA values increased(P = 0.026). The BEC values of high myopia were higher than those of low and moderate myopia groups. When the loss function of our data classification model converged to 0.09,the model accuracy reached 94.19%

Zhihao Zhao, Shahrooz Faghihroohi, Yinzheng Zhao et al.

Background and Objective: In the realm of ophthalmic imaging, accurate vascular segmentation is paramount for diagnosing and managing various eye diseases. Contemporary deep learning-based vascular segmentation models rival human accuracy but still face substantial challenges in accurately segmenting minuscule blood vessels in neural network applications. Due to the necessity of multiple downsampling operations in the CNN models, fine details from high-resolution images are inevitably lost. The objective of this study is to design a structure to capture the delicate and small blood vessels. Methods: To address these issues, we propose a novel network (KaLDeX) for vascular segmentation leveraging a Kalman filter based linear deformable cross attention (LDCA) module, integrated within a UNet++ framework. Our approach is based on two key components: Kalman filter (KF) based linear deformable convolution (LD) and cross-attention (CA) modules. The LD module is designed to adaptively adjust the focus on thin vessels that might be overlooked in standard convolution. The CA module improves the global understanding of vascular structures by aggregating the detailed features from the LD module with the high level features from the UNet++ architecture. Finally, we adopt a topological loss function based on persistent homology to constrain the topological continuity of the segmentation. Results: The proposed method is evaluated on retinal fundus image datasets (DRIVE, CHASE_BD1, and STARE) as well as the 3mm and 6mm of the OCTA-500 dataset, achieving an average accuracy (ACC) of 97.25%, 97.77%, 97.85%, 98.89%, and 98.21%, respectively. Conclusions: Empirical evidence shows that our method outperforms the current best models on different vessel segmentation datasets. Our source code is available at: https://github.com/AIEyeSystem/KalDeX.

Zhihao Zhao, Junjie Yang, Shahrooz Faghihroohi et al.

The utilization of longitudinal datasets for glaucoma progression prediction offers a compelling approach to support early therapeutic interventions. Predominant methodologies in this domain have primarily focused on the direct prediction of glaucoma stage labels from longitudinal datasets. However, such methods may not adequately encapsulate the nuanced developmental trajectory of the disease. To enhance the diagnostic acumen of medical practitioners, we propose a novel diffusion-based model to predict prospective images by extrapolating from existing longitudinal fundus images of patients. The methodology delineated in this study distinctively leverages sequences of images as inputs. Subsequently, a time-aligned mask is employed to select a specific year for image generation. During the training phase, the time-aligned mask resolves the issue of irregular temporal intervals in longitudinal image sequence sampling. Additionally, we utilize a strategy of randomly masking a frame in the sequence to establish the ground truth. This methodology aids the network in continuously acquiring knowledge regarding the internal relationships among the sequences throughout the learning phase. Moreover, the introduction of textual labels is instrumental in categorizing images generated within the sequence. The empirical findings from the conducted experiments indicate that our proposed model not only effectively generates longitudinal data but also significantly improves the precision of downstream classification tasks.

Zhihao Zhao, Yinzheng Zhao, Junjie Yang et al.

Recent advancements in foundation models, such as the Segment Anything Model (SAM), have significantly impacted medical image segmentation, especially in retinal imaging, where precise segmentation is vital for diagnosis. Despite this progress, current methods face critical challenges: 1) modality ambiguity in textual disease descriptions, 2) a continued reliance on manual prompting for SAM-based workflows, and 3) a lack of a unified framework, with most methods being modality- and task-specific. To overcome these hurdles, we propose CLIP-unified Auto-Prompt Segmentation (\CLAPS), a novel method for unified segmentation across diverse tasks and modalities in retinal imaging. Our approach begins by pre-training a CLIP-based image encoder on a large, multi-modal retinal dataset to handle data scarcity and distribution imbalance. We then leverage GroundingDINO to automatically generate spatial bounding box prompts by detecting local lesions. To unify tasks and resolve ambiguity, we use text prompts enhanced with a unique "modality signature" for each imaging modality. Ultimately, these automated textual and spatial prompts guide SAM to execute precise segmentation, creating a fully automated and unified pipeline. Extensive experiments on 12 diverse datasets across 11 critical segmentation categories show that CLAPS achieves performance on par with specialized expert models while surpassing existing benchmarks across most metrics, demonstrating its broad generalizability as a foundation model.