GLEAM: A Multimodal Imaging Dataset and HAMM for Glaucoma Classification

Accurate diagnosis of glaucoma is challenging, as early-stage changes are subtle and often lack clear structural or appearance cues. Most existing approaches rely on a single modality, such as fundus or optical coherence tomography (OCT), capturing only partial pathological information and often missing early disease progression. In this paper, we propose an iterative multimodal optimization model (IMO) for joint segmentation and grading. IMO integrates fundus and OCT features through a mid-level fusion strategy, enhanced by a cross-modal feature alignment (CMFA) module to reduce modality discrepancies. An iterative refinement decoder progressively optimizes the multimodal features through a denoising diffusion mechanism, enabling fine-grained segmentation of the optic disc and cup while supporting accurate glaucoma grading. Extensive experiments show that our method effectively integrates multimodal features, providing a comprehensive and clinically significant approach to glaucoma assessment. Source codes are available at https://github.com/warren-wzw/IMO.git.

Glaucoma is a progressive eye disease that can lead to irreversible vision loss if not detected at an early stage. Conventional diagnostic procedures are often time-consuming and rely heavily on expert interpretation, limiting their scalability for large-scale screening. In this study, glaucoma detection is investigated under two evaluation settings: sample-wise, where individual samples are analyzed independently, and patient-wise, where data from each patient are aggregated for final prediction. An automated multimodal framework is proposed that integrates fundus images with clinical data. Under the sample-wise setting, detection is performed using fundus images and clinical features individually, as well as through their multimodal combination. Under the patient-wise setting, predictions are obtained by aggregating multiple fundus image representations with corresponding clinical information for each patient. Deep visual features are extracted using a Vision Transformer (ViT) architecture and classified using classical machine-learning models, with a stacking-based ensemble of the three best-performing classifiers employed to optimize performance. Experiments conducted on the publicly available PAPILA dataset demonstrate strong diagnostic performance, achieving 97.47% accuracy and a 97.50% F1-score for sample-wise multimodal classification, and 98.97% accuracy and F1-score for subject-wise detection. The proposed framework is further deployed as an end-to-end web-based platform to support automated glaucoma screening and clinical decision support.

Early and accurate glaucoma detection is critical to prevent irreversible vision loss, yet existing AI methods often rely on unimodal inputs and lack interpretability. We present GlaBoost, a multimodal gradient boosting framework that unifies three complementary signals for glaucoma risk prediction: fundus image embeddings from a pretrained convolutional encoder,free-text neuroretinal rim assessments encoded by a transformer-based language model, and structured ophthalmic biomarkers. These modalities are fused into a single representation and classified by an enhanced XGBoost model.On two real-world annotated datasets, GlaBoost consistently outperforms unimodal and generic multimodal baselines. Feature importance analysis highlights the cup-to-disc ratio, rim thinning, and the ISNT rule as the dominant predictors, yielding clinically consistent and interpretable decisions. GlaBoost offers a transparent and scalable foundation for multimodal decision support in ophthalmology.