Detecting anomalies in fundus images through unsupervised methods is a challenging task due to the similarity between normal and abnormal tissues, as well as their indistinct boundaries. The current methods have limitations in accurately detecting subtle anomalies while avoiding false positives. To address these challenges, we propose the ReSynthDetect network which utilizes a reconstruction network for modeling normal images, and an anomaly generator that produces synthetic anomalies consistent with the appearance of fundus images. By combining the features of consistent anomaly generation and image reconstruction, our method is suited for detecting fundus abnormalities. The proposed approach has been extensively tested on benchmark datasets such as EyeQ and IDRiD, demonstrating state-of-the-art performance in both image-level and pixel-level anomaly detection. Our experiments indicate a substantial 9% improvement in AUROC on EyeQ and a significant 17.1% improvement in AUPR on IDRiD.

Accurate fovea localization is essential for analyzing retinal diseases to prevent irreversible vision loss. While current deep learning-based methods outperform traditional ones, they still face challenges such as the lack of local anatomical landmarks around the fovea, the inability to robustly handle diseased retinal images, and the variations in image conditions. In this paper, we propose a novel transformer-based architecture called DualStreamFoveaNet (DSFN) for multi-cue fusion. This architecture explicitly incorporates long-range connections and global features using retina and vessel distributions for robust fovea localization. We introduce a spatial attention mechanism in the dual-stream encoder to extract and fuse self-learned anatomical information, focusing more on features distributed along blood vessels and significantly reducing computational costs by decreasing token numbers. Our extensive experiments show that the proposed architecture achieves state-of-the-art performance on two public datasets and one large-scale private dataset. Furthermore, we demonstrate that the DSFN is more robust on both normal and diseased retina images and has better generalization capacity in cross-dataset experiments.

Recently anomaly detection has drawn much attention in diagnosing ocular diseases. Most existing anomaly detection research in fundus images has relatively large anomaly scores in the salient retinal structures, such as blood vessels, optical cups and discs. In this paper, we propose a Region and Spatial Aware Anomaly Detection (ReSAD) method for fundus images, which obtains local region and long-range spatial information to reduce the false positives in the normal structure. ReSAD transfers a pre-trained model to extract the features of normal fundus images and applies the Region-and-Spatial-Aware feature Combination module (ReSC) for pixel-level features to build a memory bank. In the testing phase, ReSAD uses the memory bank to determine out-of-distribution samples as abnormalities. Our method significantly outperforms the existing anomaly detection methods for fundus images on two publicly benchmark datasets.