Fundus Image Quality Assessment and Enhancement: a Systematic Review

As an affordable and convenient eye scan, fundus photography holds the potential for preventing vision impairment, especially in resource-limited regions. However, fundus image degradation is common under intricate imaging environments, impacting following diagnosis and treatment. Consequently, image quality assessment (IQA) and enhancement (IQE) are essential for ensuring the clinical value and reliability of fundus images. While existing reviews offer some overview of this field, a comprehensive analysis of the interplay between IQA and IQE, along with their clinical deployment challenges, is lacking. This paper addresses this gap by providing a thorough review of fundus IQA and IQE algorithms, research advancements, and practical applications. We outline the fundamentals of the fundus photography imaging system and the associated interferences, and then systematically summarize the paradigms in fundus IQA and IQE. Furthermore, we discuss the practical challenges and solutions in deploying IQA and IQE, as well as offer insights into potential future research directions.