Liqin Gao

Yukun Guo, Tristan T. Hormel, An-Lun Wu et al.

To develop and evaluate deep learning models for automated grading of age-related macular degeneration (AMD) severity using optical coherence tomography (OCT) and OCT angiography (OCTA) data. Two hundred seventy-one participants aged >= 50 years with varying AMD severities. Central macular 6 x 6 mm OCT/OCTA volumes were acquired using a swept-source OCTA system (SOLIX; Visionix/Optovue Inc., CA). AMD severity was graded into four stages (No AMD, Early AMD, Intermediate AMD, and Advanced AMD) according to the AREDS simplified severity scale. Three deep learning models were developed using different input modalities: (1) biomarker maps derived from segmented pathological features, including retinal fluid, drusen, geographic atrophy (GA), and macular neovascularization (MNV); (2) two-dimensional (2D) en face OCT and OCTA projections; and (3) three-dimensional (3D) OCT/OCTA volumes. EfficientNet-based architectures were trained using normalized inputs, data augmentation, and five-fold cross-validation. A total of 2,030 OCT/OCTA volumes from 351 eyes of 271 participants were analyzed. All models demonstrated strong AMD staging performance with substantial agreement with the reference standard (QWK >= 0.83). The biomarker-based model achieved the highest overall performance (QWK = 0.85 +/- 0.03, mean +/- standard deviation) and the best detection of early AMD (F1-score = 0.59 +/- 0.14). The 3D model achieved performance comparable to the 2D OCT/OCTA model (QWK = 0.83 +/- 0.04 vs. 0.83 +/- 0.09), while the 2D OCT/OCTA model showed the highest precision (0.79 +/- 0.06) and most accurately identified eyes without AMD. Deep learning models using OCT/OCTA data can accurately and automatically grade AMD severity. Among the evaluated approaches, the biomarker-based model provided the most balanced performance and showed particular value for early AMD detection.

Jinyi Hao, Jie Wang, Liqin Gao et al.

Retinal neovascularization (RNV) is a vision threatening development in diabetic retinopathy (DR). Vision loss associated with RNV is preventable with timely intervention, making RNV clinical screening and monitoring a priority. Optical coherence tomography (OCT) angiography (OCTA) provides high-resolution imaging and high-sensitivity detection of RNV lesions. With recent commercial devices introducing widefield OCTA imaging to the clinic, the technology stands to improve early detection of RNV pathology. However, to meet clinical requirements these imaging capabilities must be combined with effective RNV detection and quantification, but existing algorithms for OCTA images are optimized for conventional, i.e. narrow, fields of view. Here, we present a novel approach for RNV diagnosis and staging on widefield OCT/OCTA. Unlike conventional methods dependent on multi-layer retinal segmentation, our model reframes RNV identification as a direct binary localization task. Our fully automated approach was trained and validated on 589 widefield scans (17x17-mm to 26x21-mm) collected from multiple devices at multiple clinics. Our method achieved a device-dependent area under curve (AUC) ranging from 0.96 to 0.99 for RNV diagnosis, and mean intersection over union (IOU) ranging from 0.76 to 0.88 for segmentation. We also demonstrate our method's ability to monitor lesion growth longitudinally. Our results indicate that deep learning-based analysis for widefield OCTA images could offer a valuable means for improving RNV screening and management.

Shunyu An, Miao Wang, Yongchao Li et al.

This paper proposes Co-TAP (T: Triple, A: Agent, P: Protocol), a three-layer agent interaction protocol designed to address the challenges faced by multi-agent systems across the three core dimensions of Interoperability, Interaction and Collaboration, and Knowledge Sharing. We have designed and proposed a layered solution composed of three core protocols: the Human-Agent Interaction Protocol (HAI), the Unified Agent Protocol (UAP), and the Memory-Extraction-Knowledge Protocol (MEK). HAI focuses on the interaction layer, standardizing the flow of information between users, interfaces, and agents by defining a standardized, event-driven communication paradigm. This ensures the real-time performance, reliability, and synergy of interactions. As the core of the infrastructure layer, UAP is designed to break down communication barriers among heterogeneous agents through unified service discovery and protocol conversion mechanisms, thereby enabling seamless interconnection and interoperability of the underlying network. MEK, in turn, operates at the cognitive layer. By establishing a standardized ''Memory (M) - Extraction (E) - Knowledge (K)'' cognitive chain, it empowers agents with the ability to learn from individual experiences and form shareable knowledge, thereby laying the foundation for the realization of true collective intelligence. We believe this protocol framework will provide a solid engineering foundation and theoretical guidance for building the next generation of efficient, scalable, and intelligent multi-agent applications.

Pengxiao Zang, Liqin Gao, Tristan T. Hormel et al.

Objective: Optical coherence tomography (OCT) and its angiography (OCTA) have several advantages for the early detection and diagnosis of diabetic retinopathy (DR). However, automated, complete DR classification frameworks based on both OCT and OCTA data have not been proposed. In this study, a convolutional neural network (CNN) based method is proposed to fulfill a DR classification framework using en face OCT and OCTA. Methods: A densely and continuously connected neural network with adaptive rate dropout (DcardNet) is designed for the DR classification. In addition, adaptive label smoothing was proposed and used to suppress overfitting. Three separate classification levels are generated for each case based on the International Clinical Diabetic Retinopathy scale. At the highest level the network classifies scans as referable or non-referable for DR. The second level classifies the eye as non-DR, non-proliferative DR (NPDR), or proliferative DR (PDR). The last level classifies the case as no DR, mild and moderate NPDR, severe NPDR, and PDR. Results: We used 10-fold cross-validation with 10% of the data to assess the networks performance. The overall classification accuracies of the three levels were 95.7%, 85.0%, and 71.0% respectively. Conclusion/Significance: A reliable, sensitive and specific automated classification framework for referral to an ophthalmologist can be a key technology for reducing vision loss related to DR.