Retinal Layer Segmentation in OCT Images With 2.5D Cross-slice Feature Fusion Module for Glaucoma Assessment

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.

Optical Coherence Tomography (OCT) layer segmentation faces challenges due to annotation scarcity and heterogeneous label granularities across datasets. While semi-supervised learning helps alleviate label scarcity, existing methods typically assume a fixed granularity, failing to fully exploit cross-granularity supervision. This paper presents LUMOS, a semi-supervised universal OCT retinal layer segmentation framework based on a Dual-Decoder Network with a Hierarchical Prompting Strategy (DDN-HPS) and Reliable Progressive Multi-granularity Learning (RPML). DDN-HPS combines a dual-branch architecture with a multi-granularity prompting strategy to effectively suppress pseudo-label noise propagation. Meanwhile, RPML introduces region-level reliability weighing and a progressive training approach that guides the model from easier to more difficult tasks, ensuring the reliable selection of cross-granularity consistency targets, thereby achieving stable cross-granularity alignment. Experiments on six OCT datasets demonstrate that LUMOS largely outperforms existing methods and exhibits exceptional cross-domain and cross-granularity generalization capability.

Diabetic retinopathy (DR) is a leading cause of vision impairment worldwide, highlighting the need for accurate and accessible screening tools. Optical Coherence Tomography (OCT) provides high-resolution structural information of the retina, whereas OCT angiography (OCTA) offers complementary vascular information that is highly relevant for DR diagnosis. In this study, we propose a cross-modal fusion of OCT B-scans with single-channel en face OCTA using a bidirectional cross-modal attention network for automated DR classification. Two independent datasets, OCT500 and UIC, comprising 730 subjects in total, were utilized to evaluate performance under within-dataset, combined-dataset, and cross-dataset generalization settings. A ConvNeXt V2 model trained solely on OCT images served as the unimodal baseline. In addition to ground-truth (GT) OCTA, we explored the use of translated (TR) OCTA generated from OCT scans, eliminating the requirement for dedicated OCTA hardware. Experimental results demonstrate that cross-modal fusion consistently outperforms unimodal OCT classification across all evaluation scenarios. Fusion with GT OCTA improved classification accuracy and discriminative performance, while TR OCTA achieved comparable or superior results in most settings. Furthermore, TR OCTA improved sensitivity and cross-dataset generalization, indicating enhanced robustness to domain shifts. These findings demonstrate that attention-based OCT-OCTA en face fusion provides clinically meaningful improvements for DR detection and suggest that computationally generated OCTA can serve as a practical, low-cost alternative to hardware-acquired OCTA, enabling broader deployment of high-performance retinal screening systems in resource-limited clinical environments.