Risa Higashita

Zunjie Xiao, Xiaoqing Zhang, Risa Higashita et al.

Ophthalmic image segmentation serves as a critical foundation for ocular disease diagnosis. Although fully convolutional neural networks (CNNs) are commonly employed for segmentation, they are constrained by inductive biases and face challenges in establishing long-range dependencies. Transformer-based models address these limitations but introduce substantial computational overhead. Recently, a simple yet efficient Multilayer Perceptron (MLP) architecture was proposed for image classification, achieving competitive performance relative to advanced transformers. However, its effectiveness for ophthalmic image segmentation remains unexplored. In this paper, we introduce MM-UNet, an efficient Mixed MLP model tailored for ophthalmic image segmentation. Within MM-UNet, we propose a multi-scale MLP (MMLP) module that facilitates the interaction of features at various depths through a grouping strategy, enabling simultaneous capture of global and local information. We conducted extensive experiments on both a private anterior segment optical coherence tomography (AS-OCT) image dataset and a public fundus image dataset. The results demonstrated the superiority of our MM-UNet model in comparison to state-of-the-art deep segmentation networks.

Zunjie Xiao, Xiao Wu, Tianhang Liu et al.

Precise lens structure segmentation is essential for the design of intraocular lenses (IOLs) in cataract surgery. Existing deep segmentation networks typically weight all pixels equally under cross-entropy (CE) loss, overlooking the fact that sub-regions of lens structures are inhomogeneous (e.g., some regions perform better than others) and that boundary regions often suffer from poor segmentation calibration at the pixel level. Clinically, experts annotate different sub-regions of lens structures with varying confidence levels, considering factors such as sub-region proportions, ambiguous boundaries, and lens structure shapes. Motivated by this observation, we propose an Adaptive Confidence-Wise (ACW) loss to group each lens structure sub-region into different confidence sub-regions via a confidence threshold from the unique region aspect, aiming to exploit the potential of expert annotation confidence prior. Specifically, ACW clusters each target region into low-confidence and high-confidence groups and then applies a region-weighted loss to reweigh each confidence group. Moreover, we design an adaptive confidence threshold optimization algorithm to adjust the confidence threshold of ACW dynamically. Additionally, to better quantify the miscalibration errors in boundary region segmentation, we propose a new metric, termed Boundary Expected Calibration Error (BECE). Extensive experiments on a clinical lens structure AS-OCT dataset and other multi-structure datasets demonstrate that our ACW significantly outperforms competitive segmentation loss methods across different deep segmentation networks (e.g., MedSAM). Notably, our method surpasses CE with 6.13% IoU gain, 4.33% DSC increase, and 4.79% BECE reduction in lens structure segmentation under U-Net. The code of this paper is available at https://github.com/XiaoLing12138/Adaptive-Confidence-Wise-Loss.

Yinglin Zhang, Ruiling Xi, Huazhu Fu et al.

Robust and accurate segmentation for elongated physiological structures is challenging, especially in the ambiguous region, such as the corneal endothelium microscope image with uneven illumination or the fundus image with disease interference. In this paper, we present a spatial and scale uncertainty-aware network (SSU-Net) that fully uses both spatial and scale uncertainty to highlight ambiguous regions and integrate hierarchical structure contexts. First, we estimate epistemic and aleatoric spatial uncertainty maps using Monte Carlo dropout to approximate Bayesian networks. Based on these spatial uncertainty maps, we propose the gated soft uncertainty-aware (GSUA) module to guide the model to focus on ambiguous regions. Second, we extract the uncertainty under different scales and propose the multi-scale uncertainty-aware (MSUA) fusion module to integrate structure contexts from hierarchical predictions, strengthening the final prediction. Finally, we visualize the uncertainty map of final prediction, providing interpretability for segmentation results. Experiment results show that the SSU-Net performs best on cornea endothelial cell and retinal vessel segmentation tasks. Moreover, compared with counterpart uncertainty-based methods, SSU-Net is more accurate and robust.

Yinglin Zhang, Risa Higashita, Huazhu Fu et al.

Corneal endothelial cell segmentation plays a vital role inquantifying clinical indicators such as cell density, coefficient of variation,and hexagonality. However, the corneal endothelium's uneven reflectionand the subject's tremor and movement cause blurred cell edges in theimage, which is difficult to segment, and need more details and contextinformation to release this problem. Due to the limited receptive field oflocal convolution and continuous downsampling, the existing deep learn-ing segmentation methods cannot make full use of global context andmiss many details. This paper proposes a Multi-Branch hybrid Trans-former Network (MBT-Net) based on the transformer and body-edgebranch. Firstly, We use the convolutional block to focus on local tex-ture feature extraction and establish long-range dependencies over space,channel, and layer by the transformer and residual connection. Besides,We use the body-edge branch to promote local consistency and to provideedge position information. On the self-collected dataset TM-EM3000 andpublic Alisarine dataset, compared with other State-Of-The-Art (SOTA)methods, the proposed method achieves an improvement.

Xiaoqing Zhang, Yan Hu, Zunjie Xiao et al.

Cataracts are the leading cause of visual impairment and blindness globally. Over the years, researchers have achieved significant progress in developing state-of-the-art machine learning techniques for automatic cataract classification and grading, aiming to prevent cataracts early and improve clinicians' diagnosis efficiency. This survey provides a comprehensive survey of recent advances in machine learning techniques for cataract classification/grading based on ophthalmic images. We summarize existing literature from two research directions: conventional machine learning methods and deep learning methods. This survey also provides insights into existing works of both merits and limitations. In addition, we discuss several challenges of automatic cataract classification/grading based on machine learning techniques and present possible solutions to these challenges for future research.