An Ran Ran

Weiwen Zhang, Dawei Yang, Haoxuan Che et al.

For optical coherence tomography angiography (OCTA) images, a limited scanning rate leads to a trade-off between field-of-view (FOV) and imaging resolution. Although larger FOV images may reveal more parafoveal vascular lesions, their application is greatly hampered due to lower resolution. To increase the resolution, previous works only achieved satisfactory performance by using paired data for training, but real-world applications are limited by the challenge of collecting large-scale paired images. Thus, an unpaired approach is highly demanded. Generative Adversarial Network (GAN) has been commonly used in the unpaired setting, but it may struggle to accurately preserve fine-grained capillary details, which are critical biomarkers for OCTA. In this paper, our approach aspires to preserve these details by leveraging the frequency information, which represents details as high-frequencies ($\textbf{hf}$) and coarse-grained backgrounds as low-frequencies ($\textbf{lf}$). In general, we propose a GAN-based unpaired super-resolution method for OCTA images and exceptionally emphasize $\textbf{hf}$ fine capillaries through a dual-path generator. To facilitate a precise spectrum of the reconstructed image, we also propose a frequency-aware adversarial loss for the discriminator and introduce a frequency-aware focal consistency loss for end-to-end optimization. Experiments show that our method outperforms other state-of-the-art unpaired methods both quantitatively and visually.

Qingshan Hou, Yukun Zhou, Jocelyn Hui Lin Goh et al.

The advent of foundation models (FMs) is transforming medical domain. In ophthalmology, RETFound, a retina-specific FM pre-trained sequentially on 1.4 million natural images and 1.6 million retinal images, has demonstrated high adaptability across clinical applications. Conversely, DINOv2, a general-purpose vision FM pre-trained on 142 million natural images, has shown promise in non-medical domains. However, its applicability to clinical tasks remains underexplored. To address this, we conducted head-to-head evaluations by fine-tuning RETFound and three DINOv2 models (large, base, small) for ocular disease detection and systemic disease prediction tasks, across eight standardized open-source ocular datasets, as well as the Moorfields AlzEye and the UK Biobank datasets. DINOv2-large model outperformed RETFound in detecting diabetic retinopathy (AUROC=0.850-0.952 vs 0.823-0.944, across three datasets, all P<=0.007) and multi-class eye diseases (AUROC=0.892 vs. 0.846, P<0.001). In glaucoma, DINOv2-base model outperformed RETFound (AUROC=0.958 vs 0.940, P<0.001). Conversely, RETFound achieved superior performance over all DINOv2 models in predicting heart failure, myocardial infarction, and ischaemic stroke (AUROC=0.732-0.796 vs 0.663-0.771, all P<0.001). These trends persisted even with 10% of the fine-tuning data. These findings showcase the distinct scenarios where general-purpose and domain-specific FMs excel, highlighting the importance of aligning FM selection with task-specific requirements to optimise clinical performance.

Yuyan Ruan, Dawei Yang, Ziqi Tang et al.

Optical coherence tomography angiography (OCTA) is a new imaging modality to visualize retinal microvasculature and has been readily adopted in clinics. High-resolution OCT angiograms are important to qualitatively and quantitatively identify potential biomarkers for different retinal diseases accurately. However, one significant problem of OCTA is the inevitable decrease in resolution when increasing the field-of-view given a fixed acquisition time. To address this issue, we propose a novel reference-based super-resolution (RefSR) framework to preserve the resolution of the OCT angiograms while increasing the scanning area. Specifically, textures from the normal RefSR pipeline are used to train a learnable texture generator (LTG), which is designed to generate textures according to the input. The key difference between the proposed method and traditional RefSR models is that the textures used during inference are generated by the LTG instead of being searched from a single reference image. Since the LTG is optimized throughout the whole training process, the available texture space is significantly enlarged and no longer limited to a single reference image, but extends to all textures contained in the training samples. Moreover, our proposed LTGNet does not require a reference image at the inference phase, thereby becoming invulnerable to the selection of the reference image. Both experimental and visual results show that LTGNet has superior performance and robustness over state-of-the-art methods, indicating good reliability and promise in real-life deployment. The source code will be made available upon acceptance.

Erfan Noury, Suria S. Mannil, Robert T. Chang et al.

We describe a new approach to automated Glaucoma detection in 3D Spectral Domain Optical Coherence Tomography (OCT) optic nerve scans. First, we gathered a unique and diverse multi-ethnic dataset of OCT scans consisting of glaucoma and non-glaucomatous cases obtained from four tertiary care eye hospitals located in four different countries. Using this longitudinal data, we achieved state-of-the-art results for automatically detecting Glaucoma from a single raw OCT using a 3D Deep Learning system. These results are close to human doctors in a variety of settings across heterogeneous datasets and scanning environments. To verify correctness and interpretability of the automated categorization, we used saliency maps to find areas of focus for the model. Matching human doctor behavior, the model predictions indeed correlated with the conventional diagnostic parameters in the OCT printouts, such as the retinal nerve fiber layer. We further used our model to find new areas in the 3D data that are presently not being identified as a diagnostic parameter to detect glaucoma by human doctors. Namely, we found that the Lamina Cribrosa (LC) region can be a valuable source of helpful diagnostic information previously unavailable to doctors during routine clinical care because it lacks a quantitative printout. Our model provides such volumetric quantification of this region. We found that even when a majority of the RNFL is removed, the LC region can distinguish glaucoma. This is clinically relevant in high myopes, when the RNFL is already reduced, and thus the LC region may help differentiate glaucoma in this confounding situation. We further generalize this approach to create a new algorithm called DiagFind that provides a recipe for finding new diagnostic information in medical imagery that may have been previously unusable by doctors.