--Interpretability is crucial to enhance trust in machine learning models for medical diagnostics. However, most state-of-the-art image classifiers based on neural networks are not interpretable. As a result, clinicians often resort to known biomarkers for diagnosis, although biomarker-based classification typically performs worse than large neural networks. This work proposes a method that surpasses the performance of established machine learning models while simultaneously improving prediction interpretability for diabetic retinopathy staging from optical coherence tomography angiography (OCT A) images. Our method is based on a novel biology-informed heterogeneous graph representation that models retinal vessel segments, intercapillary areas, and the foveal avascular zone (F AZ) in a human-interpretable way. This graph representation allows us to frame diabetic retinopathy staging as a graph-level classification task, which we solve using an efficient graph neural network. Our model outperforms all baselines on two datasets. Crucially, we use our biology-informed graph to provide explanations of unprecedented detail. In addition, we give informative and human-interpretable attributions to critical characteristics. Our work contributes to the development of clinical decision-support tools in ophthalmology. Diabetic Retinopathy (DR), a complication of diabetes that affects the retinal vasculature, is one of the leading causes of blindness in adulthood [1]. It is associated with pathological changes to the retinal microvasculature, resulting in a widening of the intercapillary areas, and enlargement of the foveal avascular zone (FAZ). Currently, clinicians study biomarkers that capture these changes, such as blood vessel density (BVD), Fractal Dimension (FD), and FAZ area.

Early detection of dementia, such as Alzheimer's disease (AD) or mild cognitive impairment (MCI), is essential to enable timely intervention and potential treatment. Accurate detection of AD/MCI is challenging due to the high complexity, cost, and often invasive nature of current diagnostic techniques, which limit their suitability for large-scale population screening. Given the shared embryological origins and physiological characteristics of the retina and brain, retinal imaging is emerging as a potentially rapid and cost-effective alternative for the identification of individuals with or at high risk of AD. In this paper, we present a novel PolarNet+ that uses retinal optical coherence tomography angiography (OCTA) to discriminate early-onset AD (EOAD) and MCI subjects from controls. Our method first maps OCTA images from Cartesian coordinates to polar coordinates, allowing approximate sub-region calculation to implement the clinician-friendly early treatment of diabetic retinopathy study (ETDRS) grid analysis. We then introduce a multi-view module to serialize and analyze the images along three dimensions for comprehensive, clinically useful information extraction. Finally, we abstract the sequence embedding into a graph, transforming the detection task into a general graph classification problem. A regional relationship module is applied after the multi-view module to excavate the relationship between the sub-regions. Such regional relationship analyses validate known eye-brain links and reveal new discriminative patterns.

Purpose: This study explores the feasibility of using generative machine learning (ML) to translate Optical Coherence Tomography (OCT) images into Optical Coherence Tomography Angiography (OCTA) images, potentially bypassing the need for specialized OCTA hardware. Methods: The method involved implementing a generative adversarial network framework that includes a 2D vascular segmentation model and a 2D OCTA image translation model. The study utilizes a public dataset of 500 patients, divided into subsets based on resolution and disease status, to validate the quality of TR-OCTA images. The validation employs several quality and quantitative metrics to compare the translated images with ground truth OCTAs (GT-OCTA). We then quantitatively characterize vascular features generated in TR-OCTAs with GT-OCTAs to assess the feasibility of using TR-OCTA for objective disease diagnosis. Result: TR-OCTAs showed high image quality in both 3 and 6 mm datasets (high-resolution, moderate structural similarity and contrast quality compared to GT-OCTAs). There were slight discrepancies in vascular metrics, especially in diseased patients. Blood vessel features like tortuosity and vessel perimeter index showed a better trend compared to density features which are affected by local vascular distortions. Conclusion: This study presents a promising solution to the limitations of OCTA adoption in clinical practice by using vascular features from TR-OCTA for disease detection. Translation relevance: This study has the potential to significantly enhance the diagnostic process for retinal diseases by making detailed vascular imaging more widely available and reducing dependency on costly OCTA equipment.

Optical Coherence Tomography Angiography (OCTA) is a non-invasive imaging technique that provides high-resolution cross-sectional images of the retina, which are useful for diagnosing and monitoring various retinal diseases. However, manual segmentation of OCTA images is a time-consuming and labor-intensive task, which motivates the development of automated segmentation methods. In this paper, we propose a novel multi-task learning method for OCTA segmentation, called OCTA-MTL, that leverages an image-to-DT (Distance Transform) branch and an adaptive loss combination strategy. The image-to-DT branch predicts the distance from each vessel voxel to the vessel surface, which can provide useful shape prior and boundary information for the segmentation task. The adaptive loss combination strategy dynamically adjusts the loss weights according to the inverse of the average loss values of each task, to balance the learning process and avoid the dominance of one task over the other. We evaluate our method on the ROSE-2 dataset its superiority in terms of segmentation performance against two baseline methods: a single-task segmentation method and a multi-task segmentation method with a fixed loss combination.

Image data set from a multi-spectral animal imaging system is used to address two issues: (a) registering the oscillation in optical coherence tomography (OCT) images due to mouse eye movement and (b) suppressing the shadow region under the thick vessels/structures. Several classical and AI-based algorithms in combination are tested for each task to see their compatibility with data from the combined animal imaging system. Hybridization of AI with optical flow followed by Homography transformation is shown to be working (correlation value>0.7) for registration. Resnet50 backbone is shown to be working better than the famous U-net model for shadow region detection with a loss value of 0.9. A simple-to-implement analytical equation is shown to be working for brightness manipulation with a 1% increment in mean pixel values and a 77% decrease in the number of zeros. The proposed equation allows formulating a constraint optimization problem using a controlling factor {\alpha} for minimization of number of zeros, standard deviation of pixel value and maximizing the mean pixel value. For Layer segmentation, the standard U-net model is used. The AI-Pipeline consists of CNN, Optical flow, RCNN, pixel manipulation model, and U-net models in sequence. The thickness estimation process has a 6% error as compared to manual annotated standard data.

Recently, diabetic retinopathy (DR) screening utilizing ultra-wide optical coherence tomography angiography (UW-OCTA) has been used in clinical practices to detect signs of early DR. However, developing a deep learning-based DR analysis system using UW-OCTA images is not trivial due to the difficulty of data collection and the absence of public datasets. By realistic constraints, a model trained on small datasets may obtain sub-par performance. Therefore, to help ophthalmologists be less confused about models' incorrect decisions, the models should be robust even in data scarcity settings. To address the above practical challenging, we present a comprehensive empirical study for DR analysis tasks, including lesion segmentation, image quality assessment, and DR grading. For each task, we introduce a robust training scheme by leveraging ensemble learning, data augmentation, and semi-supervised learning. Furthermore, we propose reliable pseudo labeling that excludes uncertain pseudo-labels based on the model's confidence scores to reduce the negative effect of noisy pseudo-labels. By exploiting the proposed approaches, we achieved 1st place in the Diabetic Retinopathy Analysis Challenge.

Abstract: Typical optical coherence tomographic angiography (OCTA) acquisition areas on commercial devices are 3 3-or 6 6-mm. Compared to 3 3-mm angiograms with proper sampling density, 6 6-mm angiograms have significantly lower scan quality, with reduced signal-to-noise ratio and worse shadow artifacts due to undersampling. Here, we propose a deep-learning-based high-resolution angiogram reconstruction network (HARNet) to generate enhanced 6 6-mm superficial vascular complex (SVC) angiograms. The network was trained on data from 3 3-mm and 6 6-mm angiograms from the same eyes. The reconstructed 6ÃŮ6-mm angiograms have significantly lower noise intensity, stronger contrast and better vascular connectivity than the original images. The algorithm did not generate false flow signal at the noise level presented by the original angiograms. The image enhancement produced by our algorithm may improve biomarker measurements and qualitative clinical assessment of 6 6-mm OCTA. 1. Introduction Optical coherence tomographic angiography (OCTA) is a noninvasive imaging technology that can capture retinal and choroidal microvasculature invivo [1]. Clinicians are rapidly adopting OCTA for evaluation of various diseases, including diabetic retinopathy (DR) [2, 3], age-related macular degeneration (AMD) [4, 5], glaucoma [6, 7], and retinal vessel occlusion (RVO) [8, 9].High-resolution and large-field-of-view OCTA improve clinical observations, provide useful biomarkers and enhance the understanding of retinal and choroidal microvascular circulations [10-13].