Accurate detection of retinal vessels plays a critical role in reflecting a wide range of health status indicators in the clinical diagnosis of ocular diseases. Recently, advances in deep learning have led to a surge in retinal vessel segmentation methods, which have significantly contributed to the quantitative analysis of vascular morphology. However, retinal vasculature differs significantly from conventional segmentation targets in that it consists of extremely thin and branching structures, whose global morphology varies greatly across images. These characteristics continue to pose challenges to segmentation precision and robustness. To address these issues, we propose MM-UNet, a novel architecture tailored for efficient retinal vessel segmentation. The model incorporates Morph Mamba Convolution layers, which replace pointwise convolutions to enhance branching topological perception through morph, state-aware feature sampling. Additionally, Reverse Selective State Guidance modules integrate reverse guidance theory with state-space modeling to improve geometric boundary awareness and decoding efficiency. Extensive experiments conducted on two public retinal vessel segmentation datasets demonstrate the superior performance of the proposed method in segmentation accuracy. Compared to the existing approaches, MM-UNet achieves F1-score gains of 1.64 % on DRIVE and 1.25 % on STARE, demonstrating its effectiveness and advancement. The project code is public via https://github.com/liujiawen-jpg/MM-UNet.

Ophthalmic image segmentation serves as a critical foundation for ocular disease diagnosis. Although fully convolutional neural networks (CNNs) are commonly employed for segmentation, they are constrained by inductive biases and face challenges in establishing long-range dependencies. Transformer-based models address these limitations but introduce substantial computational overhead. Recently, a simple yet efficient Multilayer Perceptron (MLP) architecture was proposed for image classification, achieving competitive performance relative to advanced transformers. However, its effectiveness for ophthalmic image segmentation remains unexplored. In this paper, we introduce MM-UNet, an efficient Mixed MLP model tailored for ophthalmic image segmentation. Within MM-UNet, we propose a multi-scale MLP (MMLP) module that facilitates the interaction of features at various depths through a grouping strategy, enabling simultaneous capture of global and local information. We conducted extensive experiments on both a private anterior segment optical coherence tomography (AS-OCT) image dataset and a public fundus image dataset. The results demonstrated the superiority of our MM-UNet model in comparison to state-of-the-art deep segmentation networks.