MM-UNet: A Mixed MLP Architecture for Improved Ophthalmic Image Segmentation

Ophthalmic image segmentation serves as a critical foundation for ocular disease diagnosis. Although fully convolutional neural networks (CNNs) are commonly employed for segmentation, they are constrained by inductive biases and face challenges in establishing long-range dependencies. Transformer-based models address these limitations but introduce substantial computational overhead. Recently, a simple yet efficient Multilayer Perceptron (MLP) architecture was proposed for image classification, achieving competitive performance relative to advanced transformers. However, its effectiveness for ophthalmic image segmentation remains unexplored. In this paper, we introduce MM-UNet, an efficient Mixed MLP model tailored for ophthalmic image segmentation. Within MM-UNet, we propose a multi-scale MLP (MMLP) module that facilitates the interaction of features at various depths through a grouping strategy, enabling simultaneous capture of global and local information. We conducted extensive experiments on both a private anterior segment optical coherence tomography (AS-OCT) image dataset and a public fundus image dataset. The results demonstrated the superiority of our MM-UNet model in comparison to state-of-the-art deep segmentation networks.

Elongated Physiological Structure Segmentation via Spatial and Scale Uncertainty-aware Network

Robust and accurate segmentation for elongated physiological structures is challenging, especially in the ambiguous region, such as the corneal endothelium microscope image with uneven illumination or the fundus image with disease interference. In this paper, we present a spatial and scale uncertainty-aware network (SSU-Net) that fully uses both spatial and scale uncertainty to highlight ambiguous regions and integrate hierarchical structure contexts. First, we estimate epistemic and aleatoric spatial uncertainty maps using Monte Carlo dropout to approximate Bayesian networks. Based on these spatial uncertainty maps, we propose the gated soft uncertainty-aware (GSUA) module to guide the model to focus on ambiguous regions. Second, we extract the uncertainty under different scales and propose the multi-scale uncertainty-aware (MSUA) fusion module to integrate structure contexts from hierarchical predictions, strengthening the final prediction. Finally, we visualize the uncertainty map of final prediction, providing interpretability for segmentation results. Experiment results show that the SSU-Net performs best on cornea endothelial cell and retinal vessel segmentation tasks. Moreover, compared with counterpart uncertainty-based methods, SSU-Net is more accurate and robust.

PPCR: Learning Pyramid Pixel Context Recalibration Module for Medical Image Classification

Spatial attention mechanism has been widely incorporated into deep convolutional neural networks (CNNs) via long-range dependency capturing, significantly lifting the performance in computer vision, but it may perform poorly in medical imaging. Unfortunately, existing efforts are often unaware that long-range dependency capturing has limitations in highlighting subtle lesion regions, neglecting to exploit the potential of multi-scale pixel context information to improve the representational capability of CNNs. In this paper, we propose a practical yet lightweight architectural unit, Pyramid Pixel Context Recalibration (PPCR) module, which exploits multi-scale pixel context information to recalibrate pixel position in a pixel-independent manner adaptively. PPCR first designs a cross-channel pyramid pooling to aggregate multi-scale pixel context information, then eliminates the inconsistency among them by the well-designed pixel normalization, and finally estimates per pixel attention weight via a pixel context integration. PPCR can be flexibly plugged into modern CNNs with negligible overhead. Extensive experiments on five medical image datasets and CIFAR benchmarks empirically demonstrate the superiority and generalization of PPCR over state-of-the-art attention methods. The in-depth analyses explain the inherent behavior of PPCR in the decision-making process, improving the interpretability of CNNs.

Machine Learning for Cataract Classification and Grading on Ophthalmic Imaging Modalities: A Survey

Cataract is one of the leading causes of reversible visual impairment and blindness globally. Over the years, researchers have achieved significant progress in developing state-of-the-art artificial intelligence techniques for automatic cataract classification and grading, helping clinicians prevent and treat cataract in time. This paper provides a comprehensive survey of recent advances in machine learning for cataract classification and grading based on ophthalmic images. We summarize existing literature from two research directions: conventional machine learning techniques and deep learning techniques. This paper also provides insights into existing works of both merits and limitations. In addition, we discuss several challenges of automatic cataract classification and grading based on machine learning techniques and present possible solutions to these challenges for future research.