Enhancing Fundus Image-based Glaucoma Screening via Dynamic Global-Local Feature Integration

With the advancements in medical artificial intelligence (AI), fundus image classifiers are increasingly being applied to assist in ophthalmic diagnosis. While existing classification models have achieved high accuracy on specific fundus datasets, they struggle to address real-world challenges such as variations in image quality across different imaging devices, discrepancies between training and testing images across different racial groups, and the uncertain boundaries due to the characteristics of glaucomatous cases. In this study, we aim to address the above challenges posed by image variations by highlighting the importance of incorporating comprehensive fundus image information, including the optic cup (OC) and optic disc (OD) regions, and other key image patches. Specifically, we propose a self-adaptive attention window that autonomously determines optimal boundaries for enhanced feature extraction. Additionally, we introduce a multi-head attention mechanism to effectively fuse global and local features via feature linear readout, improving the model's discriminative capability. Experimental results demonstrate that our method achieves superior accuracy and robustness in glaucoma classification.