Conventional Fourier-domain Optical Coherence Tomography (FD-OCT) systems depend on resampling into wavenumber (k) domain to extract the depth profile. This either necessitates additional hardware resources or amplifies the existing computational complexity. Moreover, the OCT images also suffer from speckle noise, due to systemic reliance on low coherence interferometry. We propose a streamlined and computationally efficient approach based on Deep-Learning (DL) which enables reconstructing speckle-reduced OCT images directly from the wavelength domain. For reconstruction, two encoder-decoder styled networks namely Spatial Domain Convolution Neural Network (SD-CNN) and Fourier Domain CNN (FD-CNN) are used sequentially. The SD-CNN exploits the highly degraded images obtained by Fourier transforming the domain fringes to reconstruct the deteriorated morphological structures along with suppression of unwanted noise. The FD-CNN leverages this output to enhance the image quality further by optimization in Fourier domain (FD). We quantitatively and visually demonstrate the efficacy of the method in obtaining high-quality OCT images. Furthermore, we illustrate the computational complexity reduction by harnessing the power of DL models. We believe that this work lays the framework for further innovations in the realm of OCT image reconstruction.

In recent years, large language models (LLMs) have demonstrated remarkable potential across various medical applications. Building on this foundation, multimodal large language models (MLLMs) integrate LLMs with visual models to process diverse inputs, including clinical data and medical images. In ophthalmology, LLMs have been explored for analyzing optical coherence tomography (OCT) reports, assisting in disease classification, and even predicting treatment outcomes. However, existing MLLM benchmarks often fail to capture the complexities of real-world clinical practice, particularly in the analysis of OCT images. Many suffer from limitations such as small sample sizes, a lack of diverse OCT datasets, and insufficient expert validation. These shortcomings hinder the accurate assessment of MLLMs' ability to interpret OCT scans and their broader applicability in ophthalmology. Our dataset, curated through rigorous quality control and expert annotation, consists of 439 fundus images and 75 OCT images. Using a standardized API-based framework, we assessed seven mainstream MLLMs and observed significant variability in diagnostic accuracy across different diseases. While some models performed well in diagnosing conditions such as diabetic retinopathy and age-related macular degeneration, they struggled with others, including choroidal neovascularization and myopia, highlighting inconsistencies in performance and the need for further refinement. Our findings emphasize the importance of developing clinically relevant benchmarks to provide a more accurate assessment of MLLMs' capabilities. By refining these models and expanding their scope, we can enhance their potential to transform ophthalmic diagnosis and treatment.

In intracoronary optical coherence tomography (OCT), blood residues and gas bubbles cause attenuation artifacts that can obscure critical vessel structures. The presence and severity of these artifacts may warrant re-acquisition, prolonging procedure time and increasing use of contrast agent. Accurate detection of these artifacts can guide targeted re-acquisition, reducing the amount of repeated scans needed to achieve diagnostically viable images. However, the highly heterogeneous appearance of these artifacts poses a challenge for the automated detection of the affected image regions. To enable automatic detection of the attenuation artifacts caused by blood residues and gas bubbles based on their severity, we propose a convolutional neural network that performs classification of the attenuation lines (A-lines) into three classes: no artifact, mild artifact and severe artifact. Our model extracts and merges features from OCT images in both Cartesian and polar coordinates, where each column of the image represents an A-line. Our method detects the presence of attenuation artifacts in OCT frames reaching F-scores of 0.77 and 0.94 for mild and severe artifacts, respectively. The inference time over a full OCT scan is approximately 6 seconds. Our experiments show that analysis of images represented in both Cartesian and polar coordinate systems outperforms the analysis in polar coordinates only, suggesting that these representations contain complementary features. This work lays the foundation for automated artifact assessment and image acquisition guidance in intracoronary OCT imaging.

Optical Coherence Tomography (OCT) provides high-resolution cross-sectional images useful for diagnosing various diseases, but their distinct characteristics from natural images raise questions about whether large-scale pre-training on datasets like ImageNet is always beneficial. In this paper, we investigate the impact of ImageNet-based pre-training on Vision Transformer (ViT) performance for OCT image classification across different dataset sizes. Our experiments cover four-category retinal pathologies (CNV, DME, Drusen, Normal). Results suggest that while pre-training can accelerate convergence and potentially offer better performance in smaller datasets, training from scratch may achieve comparable or even superior accuracy when sufficient OCT data is available. Our findings highlight the importance of matching domain characteristics in pre-training and call for further study on large-scale OCT-specific pre-training.

Optical Coherence Tomography (OCT) is a non-invasive imaging modality essential for diagnosing various eye diseases. Despite its clinical significance, developing OCT-based diagnostic tools faces challenges, such as limited public datasets, sparse annotations, and privacy concerns. Although deep learning has made progress in automating OCT analysis, these challenges remain unresolved. To address these limitations, we introduce the Vision Transformer-based Dual-Stream Self-Supervised Pretraining Network (ViT-2SPN), a novel framework designed to enhance feature extraction and improve diagnostic accuracy. ViT-2SPN employs a three-stage workflow: Supervised Pretraining, Self-Supervised Pretraining (SSP), and Supervised Fine-Tuning. The pretraining phase leverages the OCTMNIST dataset (97,477 unlabeled images across four disease classes) with data augmentation to create dual-augmented views. A Vision Transformer (ViT-Base) backbone extracts features, while a negative cosine similarity loss aligns feature representations. Pretraining is conducted over 50 epochs with a learning rate of 0.0001 and momentum of 0.999. Fine-tuning is performed on a stratified 5.129% subset of OCTMNIST using 10-fold cross-validation. ViT-2SPN achieves a mean AUC of 0.93, accuracy of 0.77, precision of 0.81, recall of 0.75, and an F1 score of 0.76, outperforming existing SSP-based methods.

Artificial intelligence (AI) methodologies hold great promise for the rapid and accurate diagnosis of coronary artery disease (CAD) from intravascular optical coherent tomography (IVOCT) images. Numerous papers have been published describing AI-based models for different diagnostic tasks, yet it remains unclear which models have potential clinical utility and have been properly validated. This systematic review considered published literature between January 2015 and February 2023 describing AI-based diagnosis of CAD using IVOCT. Our search identified 5,576 studies, with 513 included after initial screening and 35 studies included in the final systematic review after quality screening. Our findings indicate that most of the identified models are not currently suitable for clinical use, primarily due to methodological flaws and underlying biases. To address these issues, we provide recommendations to improve model quality and research practices to enhance the development of clinically useful AI products.

In this paper, we present a new approach for uncertainty-aware retinal layer segmentation in Optical Coherence Tomography (OCT) scans using probabilistic signed distance functions (SDF). Traditional pixel-wise and regression-based methods primarily encounter difficulties in precise segmentation and lack of geometrical grounding respectively. To address these shortcomings, our methodology refines the segmentation by predicting a signed distance function (SDF) that effectively parameterizes the retinal layer shape via level set. We further enhance the framework by integrating probabilistic modeling, applying Gaussian distributions to encapsulate the uncertainty in the shape parameterization. This ensures a robust representation of the retinal layer morphology even in the presence of ambiguous input, imaging noise, and unreliable segmentations. Both quantitative and qualitative evaluations demonstrate superior performance when compared to other methods. Additionally, we conducted experiments on artificially distorted datasets with various noise types--shadowing, blinking, speckle, and motion--common in OCT scans to showcase the effectiveness of our uncertainty estimation. Our findings demonstrate the possibility to obtain reliable segmentation of retinal layers, as well as an initial step towards the characterization of layer integrity, a key biomarker for disease progression.

The rising prevalence of vision-threatening retinal diseases poses a significant burden on the global healthcare systems. Deep learning (DL) offers a promising solution for automatic disease screening but demands substantial data. Collecting and labeling large volumes of ophthalmic images across various modalities encounters several real-world challenges, especially for rare diseases. Here, we introduce EyeDiff, a text-to-image model designed to generate multimodal ophthalmic images from natural language prompts and evaluate its applicability in diagnosing common and rare diseases. EyeDiff is trained on eight large-scale datasets using the advanced latent diffusion model, covering 14 ophthalmic image modalities and over 80 ocular diseases, and is adapted to ten multi-country external datasets. The generated images accurately capture essential lesional characteristics, achieving high alignment with text prompts as evaluated by objective metrics and human experts. Furthermore, integrating generated images significantly enhances the accuracy of detecting minority classes and rare eye diseases, surpassing traditional oversampling methods in addressing data imbalance. EyeDiff effectively tackles the issue of data imbalance and insufficiency typically encountered in rare diseases and addresses the challenges of collecting large-scale annotated images, offering a transformative solution to enhance the development of expert-level diseases diagnosis models in ophthalmic field.

This study introduces the Hybrid Multi-modal VGG (HM-VGG) model, a cutting-edge deep learning approach for the early diagnosis of glaucoma. The HM-VGG model utilizes an attention mechanism to process Visual Field (VF) data, enabling the extraction of key features that are vital for identifying early signs of glaucoma. Despite the common reliance on large annotated datasets, the HM-VGG model excels in scenarios with limited data, achieving remarkable results with small sample sizes. The model's performance is underscored by its high metrics in Precision, Accuracy, and F1-Score, indicating its potential for real-world application in glaucoma detection. The paper also discusses the challenges associated with ophthalmic image analysis, particularly the difficulty of obtaining large volumes of annotated data. It highlights the importance of moving beyond single-modality data, such as VF or Optical Coherence Tomography (OCT) images alone, to a multimodal approach that can provide a richer, more comprehensive dataset. This integration of different data types is shown to significantly enhance diagnostic accuracy. The HM- VGG model offers a promising tool for doctors, streamlining the diagnostic process and improving patient outcomes. Furthermore, its applicability extends to telemedicine and mobile healthcare, making diagnostic services more accessible. The research presented in this paper is a significant step forward in the field of medical image processing and has profound implications for clinical ophthalmology.

Early identification of patients at risk of cardiovascular diseases (CVD) is crucial for effective preventive care, reducing healthcare burden, and improving patients' quality of life. This study demonstrates the potential of retinal optical coherence tomography (OCT) imaging combined with fundus photographs for identifying future adverse cardiac events. We used data from 977 patients who experienced CVD within a 5-year interval post-image acquisition, alongside 1,877 control participants without CVD, totaling 2,854 subjects. We propose a novel binary classification network based on a Multi-channel Variational Autoencoder (MCVAE), which learns a latent embedding of patients' fundus and OCT images to classify individuals into two groups: those likely to develop CVD in the future and those who are not. Our model, trained on both imaging modalities, achieved promising results (AUROC 0.78 +/- 0.02, accuracy 0.68 +/- 0.002, precision 0.74 +/- 0.02, sensitivity 0.73 +/- 0.02, and specificity 0.68 +/- 0.01), demonstrating its efficacy in identifying patients at risk of future CVD events based on their retinal images. This study highlights the potential of retinal OCT imaging and fundus photographs as cost-effective, non-invasive alternatives for predicting cardiovascular disease risk. The widespread availability of these imaging techniques in optometry practices and hospitals further enhances their potential for large-scale CVD risk screening. Our findings contribute to the development of standardized, accessible methods for early CVD risk identification, potentially improving preventive care strategies and patient outcomes.