Deep Learning for Ophthalmology: The State-of-the-Art and Future Trends

The emergence of artificial intelligence (AI), particularly deep learning (DL), has marked a new era in the realm of ophthalmology, offering transformative potential for the diagnosis and treatment of posterior segment eye diseases. This review explores the cutting-edge applications of DL across a range of ocular conditions, including diabetic retinopathy, glaucoma, age-related macular degeneration, and retinal vessel segmentation. We provide a comprehensive overview of foundational ML techniques and advanced DL architectures, such as CNNs, attention mechanisms, and transformer-based models, highlighting the evolving role of AI in enhancing diagnostic accuracy, optimizing treatment strategies, and improving overall patient care. Additionally, we present key challenges in integrating AI solutions into clinical practice, including ensuring data diversity, improving algorithm transparency, and effectively leveraging multimodal data. This review emphasizes AI's potential to improve disease diagnosis and enhance patient care while stressing the importance of collaborative efforts to overcome these barriers and fully harness AI's impact in advancing eye care.

Towards Interpretable Radiology Report Generation via Concept Bottlenecks using a Multi-Agentic RAG

Deep learning has advanced medical image classification, but interpretability challenges hinder its clinical adoption. This study enhances interpretability in Chest X-ray (CXR) classification by using concept bottleneck models (CBMs) and a multi-agent Retrieval-Augmented Generation (RAG) system for report generation. By modeling relationships between visual features and clinical concepts, we create interpretable concept vectors that guide a multi-agent RAG system to generate radiology reports, enhancing clinical relevance, explainability, and transparency. Evaluation of the generated reports using an LLM-as-a-judge confirmed the interpretability and clinical utility of our model's outputs. On the COVID-QU dataset, our model achieved 81% classification accuracy and demonstrated robust report generation performance, with five key metrics ranging between 84% and 90%. This interpretable multi-agent framework bridges the gap between high-performance AI and the explainability required for reliable AI-driven CXR analysis in clinical settings.

LoGra-Med: Long Context Multi-Graph Alignment for Medical Vision-Language Model

State-of-the-art medical multi-modal large language models (med-MLLM), like LLaVA-Med or BioMedGPT, leverage instruction-following data in pre-training. However, those models primarily focus on scaling the model size and data volume to boost performance while mainly relying on the autoregressive learning objectives. Surprisingly, we reveal that such learning schemes might result in a weak alignment between vision and language modalities, making these models highly reliant on extensive pre-training datasets - a significant challenge in medical domains due to the expensive and time-consuming nature of curating high-quality instruction-following instances. We address this with LoGra-Med, a new multi-graph alignment algorithm that enforces triplet correlations across image modalities, conversation-based descriptions, and extended captions. This helps the model capture contextual meaning, handle linguistic variability, and build cross-modal associations between visuals and text. To scale our approach, we designed an efficient end-to-end learning scheme using black-box gradient estimation, enabling faster LLaMa 7B training. Our results show LoGra-Med matches LLAVA-Med performance on 600K image-text pairs for Medical VQA and significantly outperforms it when trained on 10% of the data. For example, on VQA-RAD, we exceed LLAVA-Med by 20.13% and nearly match the 100% pre-training score (72.52% vs. 72.64%). We also surpass SOTA methods like BiomedGPT on visual chatbots and RadFM on zero-shot image classification with VQA, highlighting the effectiveness of multi-graph alignment.

Enhancing Journalism with AI: A Study of Contextualized Image Captioning for News Articles using LLMs and LMMs

Large language models (LLMs) and large multimodal models (LMMs) have significantly impacted the AI community, industry, and various economic sectors. In journalism, integrating AI poses unique challenges and opportunities, particularly in enhancing the quality and efficiency of news reporting. This study explores how LLMs and LMMs can assist journalistic practice by generating contextualised captions for images accompanying news articles. We conducted experiments using the GoodNews dataset to evaluate the ability of LMMs (BLIP-2, GPT-4v, or LLaVA) to incorporate one of two types of context: entire news articles, or extracted named entities. In addition, we compared their performance to a two-stage pipeline composed of a captioning model (BLIP-2, OFA, or ViT-GPT2) with post-hoc contextualisation with LLMs (GPT-4 or LLaMA). We assess a diversity of models, and we find that while the choice of contextualisation model is a significant factor for the two-stage pipelines, this is not the case in the LMMs, where smaller, open-source models perform well compared to proprietary, GPT-powered ones. Additionally, we found that controlling the amount of provided context enhances performance. These results highlight the limitations of a fully automated approach and underscore the necessity for an interactive, human-in-the-loop strategy.

Dude: Dual Distribution-Aware Context Prompt Learning For Large Vision-Language Model

Prompt learning methods are gaining increasing attention due to their ability to customize large vision-language models to new domains using pre-trained contextual knowledge and minimal training data. However, existing works typically rely on optimizing unified prompt inputs, often struggling with fine-grained classification tasks due to insufficient discriminative attributes. To tackle this, we consider a new framework based on a dual context of both domain-shared and class-specific contexts, where the latter is generated by Large Language Models (LLMs) such as GPTs. Such dual prompt methods enhance the model's feature representation by joining implicit and explicit factors encoded in LLM knowledge. Moreover, we formulate the Unbalanced Optimal Transport (UOT) theory to quantify the relationships between constructed prompts and visual tokens. Through partial matching, UOT can properly align discrete sets of visual tokens and prompt embeddings under different mass distributions, which is particularly valuable for handling irrelevant or noisy elements, ensuring that the preservation of mass does not restrict transport solutions. Furthermore, UOT's characteristics integrate seamlessly with image augmentation, expanding the training sample pool while maintaining a reasonable distance between perturbed images and prompt inputs. Extensive experiments across few-shot classification and adapter settings substantiate the superiority of our model over current state-of-the-art baselines.

A look under the hood of the Interactive Deep Learning Enterprise (No-IDLE)

This DFKI technical report presents the anatomy of the No-IDLE prototype system (funded by the German Federal Ministry of Education and Research) that provides not only basic and fundamental research in interactive machine learning, but also reveals deeper insights into users' behaviours, needs, and goals. Machine learning and deep learning should become accessible to millions of end users. No-IDLE's goals and scienfific challenges centre around the desire to increase the reach of interactive deep learning solutions for non-experts in machine learning. One of the key innovations described in this technical report is a methodology for interactive machine learning combined with multimodal interaction which will become central when we start interacting with semi-intelligent machines in the upcoming area of neural networks and large language models.

I-MPN: Inductive Message Passing Network for Effective and Efficient Human-in-the-Loop Annotation of Mobile Eye Tracking Data

Understanding human visual processing in dynamic environments is essential for psychology and human-centered interaction design. Mobile eye-tracking systems, combining egocentric video and gaze signals, offer valuable insights. However, manual analysis of these recordings is time-intensive. In this work, we present a novel human-centered learning algorithm designed for automated object recognition within mobile eye-tracking settings. Our approach seamlessly integrates an object detector with an inductive message-passing network technique (I-MPN), harnessing node features such as node profile information and positions. This integration enables our algorithm to learn embedding functions capable of generalizing to new object angle views, thereby facilitating rapid adaptation and efficient reasoning in dynamic contexts as users navigate through their environment. Through experiments conducted on three distinct video sequences, our \textit{interactive-based method} showcases significant performance improvements over fixed training/testing algorithms, even when trained on considerably smaller annotated samples collected through user feedback. Furthermore, we showcase exceptional efficiency in data annotation processes, surpassing approaches that use complete object detectors, combine detectors with convolutional networks, or employ interactive video segmentation.

Accelerating Transformers with Spectrum-Preserving Token Merging

Increasing the throughput of the Transformer architecture, a foundational component used in numerous state-of-the-art models for vision and language tasks (e.g., GPT, LLaVa), is an important problem in machine learning. One recent and effective strategy is to merge token representations within Transformer models, aiming to reduce computational and memory requirements while maintaining accuracy. Prior works have proposed algorithms based on Bipartite Soft Matching (BSM), which divides tokens into distinct sets and merges the top k similar tokens. However, these methods have significant drawbacks, such as sensitivity to token-splitting strategies and damage to informative tokens in later layers. This paper presents a novel paradigm called PiToMe, which prioritizes the preservation of informative tokens using an additional metric termed the energy score. This score identifies large clusters of similar tokens as high-energy, indicating potential candidates for merging, while smaller (unique and isolated) clusters are considered as low-energy and preserved. Experimental findings demonstrate that PiToMe saved from 40-60\% FLOPs of the base models while exhibiting superior off-the-shelf performance on image classification (0.5\% average performance drop of ViT-MAE-H compared to 2.6\% as baselines), image-text retrieval (0.3\% average performance drop of CLIP on Flickr30k compared to 4.5\% as others), and analogously in visual questions answering with LLaVa-7B. Furthermore, PiToMe is theoretically shown to preserve intrinsic spectral properties of the original token space under mild conditions

Revealing Vulnerabilities of Neural Networks in Parameter Learning and Defense Against Explanation-Aware Backdoors

Explainable Artificial Intelligence (XAI) strategies play a crucial part in increasing the understanding and trustworthiness of neural networks. Nonetheless, these techniques could potentially generate misleading explanations. Blinding attacks can drastically alter a machine learning algorithm's prediction and explanation, providing misleading information by adding visually unnoticeable artifacts into the input, while maintaining the model's accuracy. It poses a serious challenge in ensuring the reliability of XAI methods. To ensure the reliability of XAI methods poses a real challenge, we leverage statistical analysis to highlight the changes in CNN weights within a CNN following blinding attacks. We introduce a method specifically designed to limit the effectiveness of such attacks during the evaluation phase, avoiding the need for extra training. The method we suggest defences against most modern explanation-aware adversarial attacks, achieving an approximate decrease of ~99\% in the Attack Success Rate (ASR) and a ~91\% reduction in the Mean Square Error (MSE) between the original explanation and the defended (post-attack) explanation across three unique types of attacks.

Modular Deep Active Learning Framework for Image Annotation: A Technical Report for the Ophthalmo-AI Project

Image annotation is one of the most essential tasks for guaranteeing proper treatment for patients and tracking progress over the course of therapy in the field of medical imaging and disease diagnosis. However, manually annotating a lot of 2D and 3D imaging data can be extremely tedious. Deep Learning (DL) based segmentation algorithms have completely transformed this process and made it possible to automate image segmentation. By accurately segmenting medical images, these algorithms can greatly minimize the time and effort necessary for manual annotation. Additionally, by incorporating Active Learning (AL) methods, these segmentation algorithms can perform far more effectively with a smaller amount of ground truth data. We introduce MedDeepCyleAL, an end-to-end framework implementing the complete AL cycle. It provides researchers with the flexibility to choose the type of deep learning model they wish to employ and includes an annotation tool that supports the classification and segmentation of medical images. The user-friendly interface allows for easy alteration of the AL and DL model settings through a configuration file, requiring no prior programming experience. While MedDeepCyleAL can be applied to any kind of image data, we have specifically applied it to ophthalmology data in this project.