Abstract:Structural changes in main retinal blood vessels serve as critical biomarkers for the onset and progression of glaucoma. Identifying these vessels is vital for vascular modeling yet highly challenging. This paper proposes X-GAN, a generative AI-powered unsupervised segmentation model designed for extracting main blood vessels from Optical Coherence Tomography Angiography (OCTA) images. The process begins with the Space Colonization Algorithm (SCA) to rapidly generate a skeleton of vessels, featuring their radii. By synergistically integrating generative adversarial networks (GANs) with biostatistical modeling of vessel radii, X-GAN enables a fast reconstruction of both 2D and 3D representations of the vessels. Based on this reconstruction, X-GAN achieves nearly 100\% segmentation accuracy without relying on labeled data or high-performance computing resources. Also, to address the Issue, data scarity, we introduce GSS-RetVein, a high-definition mixed 2D and 3D glaucoma retinal dataset. GSS-RetVein provides a rigorous benchmark due to its exceptionally clear capillary structures, introducing controlled noise for testing model robustness. Its 2D images feature sharp capillary boundaries, while its 3D component enhances vascular reconstruction and blood flow prediction, supporting glaucoma progression simulations. Experimental results confirm GSS-RetVein's superiority in evaluating main vessel segmentation compared to existing datasets. Code and dataset are here: https://github.com/VikiXie/SatMar8.