Organizations: Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong SAR, China · Capital Medical University, Beijing, China
Abstract
Myopia-induced posterior-pole remodeling is frequently accompanied by Optic Disc (OD) deformation and Peripapillary Atrophy (PPA), both of which provide clinically relevant structural biomarkers. In Cartesian fundus images, however, PPA often appears as an irregular and partially visible crescent adjacent to the OD, leading to fragmented segmentation and post-processing-dependent quantification. We propose UPolarSQ, a unified polar-domain framework for OD/PPA segmentation and biomarker quantification in myopic fundus images. UPolarSQ first maps an OD-centered region of interest into polar coordinates, where OD and PPA boundaries can be represented as radial profiles. It then employs UPolarSeg, a U-Net-based segmentation network enhanced with a Radial-Angular-Decoupled Module and boundary-aware auxiliary supervision to model anisotropic polar features and radial boundary transitions. Clinical biomarkers, including disc shape and PPA-width-related measurements, are deterministically extracted from the predicted polar masks, aligning segmentation and quantification within a shared geometric representation. Experiments on internal and external cohorts demonstrate that UPolarSQ improves OD/PPA segmentation and supports reliable polar-native biomarker estimation for myopic analysis.
Polarimetric imaging enables advanced vision applications such as normal estimation and de-reflection by capturing unique surface-material interactions. However, existing applications (alternatively called downstream tasks) rely on datasets constructed by naively regrouping raw measurements from division-of-focal-plane sensors, where pixels of the same polarization angle are extracted and aligned into sparse images without proper demosaicking. This reconstruction strategy results in suboptimal, incomplete targets that limit downstream performance. Moreover, current demosaicking methods are task-agnostic, optimizing only for photometric fidelity rather than utility in downstream tasks. Towards this end, we propose PolarAPP, the first framework to jointly optimize demosaicking and its downstream tasks. PolarAPP introduces a feature alignment mechanism that semantically aligns the representations of demosaicking and downstream networks via meta-learning, guiding the reconstruction to be task-aware. It further employs an equivalent imaging constraint for demosaicking training, enabling direct regression to physically meaningful outputs without relying on rearranged data. Finally, a task-refinement stage fine-tunes the task network using the stable demosaicking front-end to further enhance accuracy. Extensive experimental results demonstrate that PolarAPP outperforms existing methods in both demosaicking quality and downstream performance. Code is available upon acceptance.
Geographic atrophy (GA) secondary to age-related macular degeneration (AMD) requires precise monitoring of relevant structural biomarkers to assess disease stage, progression, and treatment response. This paper presents a fully automated, deep learning-based framework for the high-precision, pixel-wise segmentation of key biomarkers in optical coherence tomography (OCT) imaging: retinal pigment epithelium (RPE) loss, ellipsoid zone (EZ) loss, and EZ thinning. The proposed pipeline uses three specialized semantic segmentation models to delineate RPE loss, EZ boundaries (including interruptions), and Bruch's membrane. To ensure robustness and generalizability, the models were developed on a diverse dataset of 298 SD-OCT volumes representing the full phenotypic spectrum of AMD (GA:222, intermediate AMD: 40, neovascular AMD: 17, healthy: 19) and validated on an independent external dataset (n=43). The comprehensive evaluation was further strengthened using additional datasets to assess repeatability, inter-reader reliability, the impact of B-scan density on measurement accuracy, and subgroup performance stratified by lesion size. Results demonstrated high segmentation accuracy (Dice RPE loss: 0.88, Dice EZ loss: 0.87, Pearson's r > 0.99). Total EZ thickness measurements exhibited a sub-pixel average deviation of 2.15 μm, and segmentation reliability was confirmed by a strong reproducibility score (ICC > 0.98). By accurately and consistently quantifying outer photoreceptor degeneration and RPE loss, this fully automated framework provides a highly reliable tool for GA assessment in both clinical trials and routine real-world ophthalmic care.
Wolf-Dieter Vogl, Hlynur Skulason, Oliver Leingang +3
Spherical Equivalent Refraction (SER) and Axial Length (AL) are core indicators for pediatric myopia screening, yet their measurements require dedicated biometry and cycloplegic refraction. Fundus photography offers an accessible imaging modality, as myopia-related posterior-pole changes are visible in 45∘ fundus images. However, these cues are often low-contrast, spatially diffuse, and multi-scale. Moreover, AL, Sphere (SPH), and Cylinder (CYL) share partially overlapping but non-identical anatomical correlates. We propose SpecF2M, a spectral-aware multi-task network for estimating AL and SER components from pediatric fundus photographs. SpecF2M integrates a deterministic anatomy-guided enhancement module, a hybrid spatial--spectral backbone combining MixCNN and Hybrid Spectral Learning (HSL) blocks, and an expert-routing head for component-level estimation of AL, SPH, and CYL. On a pediatric cohort of 4,359 eligible child visits and 6,966 fundus images, SpecF2M outperforms controlled CNN/ViT baselines for AL and SPH estimation, achieving MAEs of 0.5347 mm and 0.7062 D, respectively. Component-level analysis further reveals asymmetric task coupling, where CYL exhibits weaker association with fundus-derived myopic patterns than AL/SPH. These results support fundus-based, screening-oriented estimation of pediatric myopia indicators, while external validation remains necessary before deployment.