Abstract:Optical Coherence Tomography (OCT) and Optical Coherence Tomography Angiography (OCTA) are key diagnostic tools for clinical evaluation and management of retinal diseases. Compared to traditional OCT, OCTA provides richer microvascular information, but its acquisition requires specialized sensors and high-cost equipment, creating significant challenges for the clinical deployment of hardware-dependent OCTA imaging methods. Given the technical complexity of OCTA image acquisition and potential mechanical artifacts, this study proposes a bidirectional image conversion framework called PupiNet, which accurately achieves bidirectional transformation between 3D OCT and 3D OCTA. The generator module of this framework innovatively integrates wavelet transformation and multi-scale attention mechanisms, significantly enhancing image conversion quality. Meanwhile, an Adaptive Discriminator Augmentation (ADA) module has been incorporated into the discriminator to optimize model training stability and convergence efficiency. To ensure clinical accuracy of vascular structures in the converted images, we designed a Vessel Structure Matcher (VSM) supervision module, achieving precise matching of vascular morphology between generated images and target images. Additionally, the Hierarchical Feature Calibration (HFC) module further guarantees high consistency of texture details between generated images and target images across different depth levels. To rigorously validate the clinical effectiveness of the proposed method, we conducted a comprehensive evaluation on a paired OCT-OCTA image dataset containing 300 eyes with various retinal pathologies. Experimental results demonstrate that PupiNet not only reliably achieves high-quality bidirectional transformation between the two modalities but also shows significant advantages in image fidelity, vessel structure preservation, and clinical usability.