Organizations: School of Electronic and Information Engineering, University of Science and Technology Liaoning, No.189 Qianshan Middle Road, Lishan District, Anshan, 114051, Liaoning, China
Abstract
Traditional Chinese Medicine (TCM) ocular inspection provides empirical cues for assessing scleral surface anomalies, but its clinical use remains subjective and difficult to quantify. To support intelligent and quantifiable ocular inspection, this study presents the TCM-inspired Artificial Intelligence Ocular Auxiliary Diagnosis System (TAO) and focuses on pixel-level scleral surface anomaly segmentation. For clinical and user-acquired images affected by multi-source distributional discrepancies, diverse anomaly morphologies, and scleral specular reflection (SSR), we propose HD-DinoMoE, a class-aware hierarchical dual mixture-of-experts network. HD-DinoMoE combines class-aware dual-stream DINOv3 feature fusion with class-specific multi-expert decoding to segment Vessels, Yellow and Black Spots, and Blood Spots. A three-stage backbone-frozen routing strategy stabilizes dual-backbone adaptation; Progressive Confidence Penalty (PCP) Loss reduces high-confidence false positives and segmentation leakage in SSR regions; and Class-Aware Adaptive Sample Weighting (CA-ASW) balances sample- and class-level training contributions. We further construct the Multi-label Scleral Anomaly Segmentation Dataset (ML-SASD), a new benchmark with Clinical, Wild, and Mix settings and pixel-wise annotations for three anomaly categories. On ML-SASD-Mix, HD-DinoMoE achieves a mean Dice of 72.11% and a mean Intersection-over-Union of 58.44%, while maintaining favorable boundary localization and specular-region false-positive control. It also shows competitive generalization on the Vessels subset of the public SBVPI dataset. These results indicate that HD-DinoMoE provides a feasible segmentation solution for TAO under complex acquisition scenarios. The code and data access information are available at https://github.com/FX-CMX/HD-DinoMoE.
Volumetric segmentation of optical coherence tomography (OCT) images is essential for diagnosing ocular diseases but requires labor-intensive voxel-wise annotations. While semi-supervised learning (SSL) can reduce annotation costs, most existing methods process data slice by slice and fail to exploit the inherent 3D spatial context. We propose PC-Seg, a progressive cross-view consistency framework that learns high-accuracy 3D segmentation models from sparse 2D annotations. Unlike conventional multi-view approaches, PC-Seg uses a single 2D model to learn cross-view consistency from standard B-scans and orthogonal slices, thereby generating reliable volumetric pseudo-labels. These pseudo-labels are then distilled into a 3D model, followed by a co-training stage in which the 2D and 3D models mutually refine each other through ensemble pseudo-labeling. Experiments on the MSHC and Duke DME datasets demonstrate that PC-Seg achieves accuracy comparable to fully supervised learning while using labels for only about 0.7% of the training data, outperforming state-of-the-art semi-supervised and retinal layer segmentation methods. Our code is publicly available at https://github.com/gsisaoki/pc-seg-official.
Anterior eye segment (AES) segmentation is a key component of both ocular biometrics and emerging clinical image analysis applications. However, heterogeneous acquisition conditions and limited annotations in medical settings hinder the robustness and generalization of existing methods. Foundation models (FMs) such as DINOv3 offer strong transfer capabilities, but efficiently adapting their representations to dense prediction tasks remains challenging. In this study, we investigate robust AES segmentation in clinical settings, and propose a lightweight architecture built upon a distilled DINOv3 ViT-Small backbone. We introduce a step-attention feature refinement module that progressively adapts multi-level transformer representations before convolutional decoding, enabling efficient exploitation of pretrained features with few parameters. We evaluate the proposed approach on a private dataset of 333 clinically acquired AES images spanning eight ophthalmic acquisition protocols and annotated for seven anatomical classes. Compared with convolutional and transformer-based baselines, including DINOv3-based methods, our approach achieves the best overall performance, reaching 85.55% mIoU when fully fine-tuned. It also demonstrates the strongest robustness to domain shift across four unseen public AES segmentation datasets. These results establish a strong baseline for robust AES segmentation in clinical settings and highlight the importance of decoder design for effectively adapting FMs representations to medical segmentation tasks.
Philippe Baumstimler, Jean-Mathieu Gagnon, Sébastien Gagné +3
Reliable automated analysis of Optical Coherence Tomography (OCT) imaging is crucial for diagnosing retinal disorders but faces a critical barrier: the need for expensive, labor-intensive expert annotations. Supervised deep learning models struggle to generalize across diverse pathologies, imaging devices, and patient populations due to their restricted vocabulary of annotated abnormalities. We propose an unsupervised anomaly detection framework that learns the normative distribution of healthy retinal anatomy without lesion annotations, directly addressing annotation efficiency challenges in clinical deployment. Our approach leverages a discrete latent model trained on normal B-scans to capture OCT-specific structural patterns. To enhance clinical robustness, we incorporate retinal layer-aware supervision and structured triplet learning to separate healthy from pathological representations, improving model reliability across varied imaging conditions. During inference, anomalies are detected and localized via reconstruction discrepancies, enabling both image and pixel-level identification without requiring disease-specific labels. On the Kermany dataset (AUROC: 0.799), our method substantially outperforms VAE, VQVAE, VQGAN, and f-AnoGAN baselines. Critically, cross-dataset evaluation on Srinivasan achieves AUROC 0.884 with superior generalization, demonstrating robust domain adaptation. On the external RETOUCH benchmark, unsupervised anomaly segmentation achieves competitive Dice (0.200) and mIoU (0.117) scores, validating reproducibility across institutions.