Retinal blood vessel segmentation is crucial for diagnosing ocular and cardiovascular diseases. Although the introduction of U-Net in 2015 by Olaf Ronneberger significantly advanced this field, yet issues like limited training data, imbalance data distribution, and inadequate feature extraction persist, hindering both the segmentation performance and optimal model generalization. Addressing these critical issues, the DEFFA-Unet is proposed featuring an additional encoder to process domain-invariant pre-processed inputs, thereby improving both richer feature encoding and enhanced model generalization. A feature filtering fusion module is developed to ensure the precise feature filtering and robust hybrid feature fusion. In response to the task-specific need for higher precision where false positives are very costly, traditional skip connections are replaced with the attention-guided feature reconstructing fusion module. Additionally, innovative data augmentation and balancing methods are proposed to counter data scarcity and distribution imbalance, further boosting the robustness and generalization of the model. With a comprehensive suite of evaluation metrics, extensive validations on four benchmark datasets (DRIVE, CHASEDB1, STARE, and HRF) and an SLO dataset (IOSTAR), demonstrate the proposed method's superiority over both baseline and state-of-the-art models. Particularly the proposed method significantly outperforms the compared methods in cross-validation model generalization.
Retinal vessel segmentation is a vital early detection method for several severe ocular diseases. Despite significant progress in retinal vessel segmentation with the advancement of Neural Networks, there are still challenges to overcome. Specifically, retinal vessel segmentation aims to predict the class label for every pixel within a fundus image, with a primary focus on intra-image discrimination, making it vital for models to extract more discriminative features. Nevertheless, existing methods primarily focus on minimizing the difference between the output from the decoder and the label, but ignore fully using feature-level fine-grained representations from the encoder. To address these issues, we propose a novel Attention U-shaped Kolmogorov-Arnold Network named AttUKAN along with a novel Label-guided Pixel-wise Contrastive Loss for retinal vessel segmentation. Specifically, we implement Attention Gates into Kolmogorov-Arnold Networks to enhance model sensitivity by suppressing irrelevant feature activations and model interpretability by non-linear modeling of KAN blocks. Additionally, we also design a novel Label-guided Pixel-wise Contrastive Loss to supervise our proposed AttUKAN to extract more discriminative features by distinguishing between foreground vessel-pixel pairs and background pairs. Experiments are conducted across four public datasets including DRIVE, STARE, CHASE_DB1, HRF and our private dataset. AttUKAN achieves F1 scores of 82.50%, 81.14%, 81.34%, 80.21% and 80.09%, along with MIoU scores of 70.24%, 68.64%, 68.59%, 67.21% and 66.94% in the above datasets, which are the highest compared to 11 networks for retinal vessel segmentation. Quantitative and qualitative results show that our AttUKAN achieves state-of-the-art performance and outperforms existing retinal vessel segmentation methods. Our code will be available at https://github.com/stevezs315/AttUKAN.
We propose a novel retinal vessel segmentation network, the Weighted Multi-Kernel Attention Network (WMKA-Net), which aims to address the issues of insufficient multiscale feature capture, loss of contextual information, and noise sensitivity in retinal vessel segmentation. WMKA-Net significantly improves the segmentation performance of small vessels and low-contrast regions by integrating several innovative components, including the MultiKernelFeature Fusion Module (MKDC), the Progressive Feature Weighting Fusion Strategy (UDFF), and the Attention Mechanism Module (AttentionBlock). The MKDC module employs multiscale parallel convolutional kernels to extract vessel characteristics, thereby enhancing the ability to capture complex vascular structures. The UDFF strategy optimizes the transmission of feature information by weighted fusion of high- and low-level features. The AttentionBlock highlights key regions and suppresses noise interference through the attention mechanism. Experimental results demonstrate that WMKA-Net achieves excellent segmentation performance in multiple public datasets, particularly in segmentation of small vessels and processing of pathological regions. This work provides a robust and efficient new method for segmentation of the retinal vessel.
Accurate retinal vessel segmentation provides essential structural information for ophthalmic image analysis. However, existing methods struggle with challenges such as multi-scale vessel variability, complex curvatures, and ambiguous boundaries. While Convolutional Neural Networks (CNNs), Transformer-based models and Mamba-based architectures have advanced the field, they often suffer from vascular discontinuities or edge feature ambiguity. To address these limitations, we propose a novel hybrid framework that synergistically integrates CNNs and Mamba for high-precision retinal vessel segmentation. Our approach introduces three key innovations: 1) The proposed High-Resolution Edge Fuse Network is a high-resolution preserving hybrid segmentation framework that combines a multi-scale backbone with the Multi-scale Retina Edge Fusion (MREF) module to enhance edge features, ensuring accurate and robust vessel segmentation. 2) The Dynamic Snake Visual State Space block combines Dynamic Snake Convolution with Mamba to adaptively capture vessel curvature details and long-range dependencies. An improved eight-directional 2D Snake-Selective Scan mechanism and a dynamic weighting strategy enhance the perception of complex vascular topologies. 3) The MREF module enhances boundary precision through multi-scale edge feature aggregation, suppressing noise while emphasizing critical vessel structures across scales. Experiments on three public datasets demonstrate that our method achieves state-of-the-art performance, particularly in maintaining vascular continuity and effectively segmenting vessels in low-contrast regions. This work provides a robust method for clinical applications requiring accurate retinal vessel analysis. The code is available at https://github.com/frank-oy/HREFNet.
Retinal vessel segmentation is critical for diagnosing ocular conditions, yet current deep learning methods are limited by modality-specific challenges and significant distribution shifts across imaging devices, resolutions, and anatomical regions. In this paper, we propose GrInAdapt, a novel framework for source-free multi-target domain adaptation that leverages multi-view images to refine segmentation labels and enhance model generalizability for optical coherence tomography angiography (OCTA) of the fundus of the eye. GrInAdapt follows an intuitive three-step approach: (i) grounding images to a common anchor space via registration, (ii) integrating predictions from multiple views to achieve improved label consensus, and (iii) adapting the source model to diverse target domains. Furthermore, GrInAdapt is flexible enough to incorporate auxiliary modalities such as color fundus photography, to provide complementary cues for robust vessel segmentation. Extensive experiments on a multi-device, multi-site, and multi-modal retinal dataset demonstrate that GrInAdapt significantly outperforms existing domain adaptation methods, achieving higher segmentation accuracy and robustness across multiple domains. These results highlight the potential of GrInAdapt to advance automated retinal vessel analysis and support robust clinical decision-making.
Generalization in medical segmentation models is challenging due to limited annotated datasets and imaging variability. To address this, we propose Retinal Layout-Aware Diffusion (RLAD), a novel diffusion-based framework for generating controllable layout-aware images. RLAD conditions image generation on multiple key layout components extracted from real images, ensuring high structural fidelity while enabling diversity in other components. Applied to retinal fundus imaging, we augmented the training datasets by synthesizing paired retinal images and vessel segmentations conditioned on extracted blood vessels from real images, while varying other layout components such as lesions and the optic disc. Experiments demonstrated that RLAD-generated data improved generalization in retinal vessel segmentation by up to 8.1%. Furthermore, we present REYIA, a comprehensive dataset comprising 586 manually segmented retinal images. To foster reproducibility and drive innovation, both our code and dataset will be made publicly accessible.
We identify two major limitations in the existing studies on retinal vessel segmentation: (1) Most existing works are restricted to one modality, i.e, the Color Fundus (CF). However, multi-modality retinal images are used every day in the study of retina and retinal diseases, and the study of vessel segmentation on the other modalities is scarce; (2) Even though a small amount of works extended their experiments to limited new modalities such as the Multi-Color Scanning Laser Ophthalmoscopy (MC), these works still require finetuning a separate model for the new modality. The finetuning will require extra training data, which is difficult to acquire. In this work, we present a foundational universal vessel segmentation model (UVSM) for multi-modality retinal images. Not only do we perform the study on a much wider range of modalities, but we also propose a universal model to segment the vessels in all these commonly-used modalities. Despite being much more versatile comparing with existing methods, our universal model still demonstrates comparable performance with the state-of-the-art finetuned methods. To the best of our knowledge, this is the first work that achieves cross-modality retinal vessel segmentation and also the first work to study retinal vessel segmentation in some novel modalities.
The U-Net architecture and its variants have remained state-of-the-art (SOTA) for retinal vessel segmentation over the past decade. In this study, we introduce a Full Scale Guided Network (FSG-Net), where the feature representation network with modernized convolution blocks extracts full-scale information and the guided convolution block refines that information. Attention-guided filter is introduced to the guided convolution block under the interpretation that the filter behaves like the unsharp mask filter. Passing full-scale information to the attention block allows for the generation of improved attention maps, which are then passed to the attention-guided filter, resulting in performance enhancement of the segmentation network. The structure preceding the guided convolution block can be replaced by any U-Net variant, which enhances the scalability of the proposed approach. For a fair comparison, we re-implemented recent studies available in public repositories to evaluate their scalability and reproducibility. Our experiments also show that the proposed network demonstrates competitive results compared to current SOTA models on various public datasets. Ablation studies demonstrate that the proposed model is competitive with much smaller parameter sizes. Lastly, by applying the proposed model to facial wrinkle segmentation, we confirmed the potential for scalability to similar tasks in other domains. Our code is available on https://github.com/ZombaSY/FSG-Net-pytorch.
The emergence of artificial intelligence (AI), particularly deep learning (DL), has marked a new era in the realm of ophthalmology, offering transformative potential for the diagnosis and treatment of posterior segment eye diseases. This review explores the cutting-edge applications of DL across a range of ocular conditions, including diabetic retinopathy, glaucoma, age-related macular degeneration, and retinal vessel segmentation. We provide a comprehensive overview of foundational ML techniques and advanced DL architectures, such as CNNs, attention mechanisms, and transformer-based models, highlighting the evolving role of AI in enhancing diagnostic accuracy, optimizing treatment strategies, and improving overall patient care. Additionally, we present key challenges in integrating AI solutions into clinical practice, including ensuring data diversity, improving algorithm transparency, and effectively leveraging multimodal data. This review emphasizes AI's potential to improve disease diagnosis and enhance patient care while stressing the importance of collaborative efforts to overcome these barriers and fully harness AI's impact in advancing eye care.
Retinal vascular morphology is crucial for diagnosing diseases such as diabetes, glaucoma, and hypertension, making accurate segmentation of retinal vessels essential for early intervention. Traditional segmentation methods assume that training and testing data share similar distributions, which can lead to poor performance on unseen domains due to domain shifts caused by variations in imaging devices and patient demographics. This paper presents a novel approach, DGSSA, for retinal vessel image segmentation that enhances model generalization by combining structural and style augmentation strategies. We utilize a space colonization algorithm to generate diverse vascular-like structures that closely mimic actual retinal vessels, which are then used to generate pseudo-retinal images with an improved Pix2Pix model, allowing the segmentation model to learn a broader range of structure distributions. Additionally, we utilize PixMix to implement random photometric augmentations and introduce uncertainty perturbations, thereby enriching stylistic diversity and significantly enhancing the model's adaptability to varying imaging conditions. Our framework has been rigorously evaluated on four challenging datasets-DRIVE, CHASEDB, HRF, and STARE-demonstrating state-of-the-art performance that surpasses existing methods. This validates the effectiveness of our proposed approach, highlighting its potential for clinical application in automated retinal vessel analysis.
Previous research on retinal vessel segmentation is targeted at a specific image domain, mostly color fundus photography (CFP). In this paper we make a brave attempt to attack a more challenging task of broad-domain retinal vessel segmentation (BD-RVS), which is to develop a unified model applicable to varied domains including CFP, SLO, UWF, OCTA and FFA. To that end, we propose Dual Convoltuional Prompting (DCP) that learns to extract domain-specific features by localized prompting along both position and channel dimensions. DCP is designed as a plug-in module that can effectively turn a R2AU-Net based vessel segmentation network to a unified model, yet without the need of modifying its network structure. For evaluation we build a broad-domain set using five public domain-specific datasets including ROSSA, FIVES, IOSTAR, PRIME-FP20 and VAMPIRE. In order to benchmark BD-RVS on the broad-domain dataset, we re-purpose a number of existing methods originally developed in other contexts, producing eight baseline methods in total. Extensive experiments show the the proposed method compares favorably against the baselines for BD-RVS.
The accurate segmentation of retinal blood vessels plays a crucial role in the early diagnosis and treatment of various ophthalmic diseases. Designing a network model for this task requires meticulous tuning and extensive experimentation to handle the tiny and intertwined morphology of retinal blood vessels. To tackle this challenge, Neural Architecture Search (NAS) methods are developed to fully explore the space of potential network architectures and go after the most powerful one. Inspired by neuronal diversity which is the biological foundation of all kinds of intelligent behaviors in our brain, this paper introduces a novel and foundational approach to neural network design, termed ``neuron programming'', to automatically search neuronal types into a network to enhance a network's representation ability at the neuronal level, which is complementary to architecture-level enhancement done by NAS. Additionally, to mitigate the time and computational intensity of neuron programming, we develop a hypernetwork that leverages the search-derived architectural information to predict optimal neuronal configurations. Comprehensive experiments validate that neuron programming can achieve competitive performance in retinal blood segmentation, demonstrating the strong potential of neuronal diversity in medical image analysis.
Purpose: Automatic and accurate segmentation of fundus vessel images has become an essential prerequisite for computer-aided diagnosis of ophthalmic diseases such as diabetes mellitus. The task of high-precision retinal vessel segmentation still faces difficulties due to the low contrast between the branch ends of retinal vessels and the background, the long and thin vessel span, and the variable morphology of the optic disc and optic cup in fundus vessel images. Methods: We propose a more advanced U-shaped architecture for a hybrid Transformer and CNN: TransUNext, which integrates an Efficient Self-attention Mechanism into the encoder and decoder of U-Net to capture both local features and global dependencies with minimal computational overhead. Meanwhile, the Global Multi-Scale Fusion (GMSF) module is further introduced to upgrade skip-connections, fuse high-level semantic and low-level detailed information, and eliminate high- and low-level semantic differences. Inspired by ConvNeXt, TransNeXt Block is designed to optimize the computational complexity of each base block in U-Net and avoid the information loss caused by the compressed dimension when the information is converted between the feature spaces of different dimensions. Results: We evaluated the proposed method on four public datasets DRIVE, STARE, CHASE-DB1, and HRF. In the experimental results, the AUC (area under the ROC curve) values were 0.9867, 0.9869, 0.9910, and 0.9887, which exceeded the other state-of-the-art.
CrackMamba, a Mamba-based model, is designed for efficient and accurate crack segmentation for monitoring the structural health of infrastructure. Traditional Convolutional Neural Network (CNN) models struggle with limited receptive fields, and while Vision Transformers (ViT) improve segmentation accuracy, they are computationally intensive. CrackMamba addresses these challenges by utilizing the VMambaV2 with pre-trained ImageNet-1k weights as the encoder and a newly designed decoder for better performance. To handle the random and complex nature of crack development, a Snake Scan module is proposed to reshape crack feature sequences, enhancing feature extraction. Additionally, the three-branch Snake Conv VSS (SCVSS) block is proposed to target cracks more effectively. Experiments show that CrackMamba achieves state-of-the-art (SOTA) performance on the CrackSeg9k and SewerCrack datasets, and demonstrates competitive performance on the retinal vessel segmentation dataset CHASE\underline{~}DB1, highlighting its generalization capability. The code is publicly available at: {https://github.com/shengyu27/CrackMamba.}
The accurate segmentation of retinal vessels in fundus images is a great challenge in medical image segmentation tasks due to their highly complex structure from other organs.Currently, deep-learning based methods for retinal cessel segmentation achieved suboptimal outcoms,since vessels with indistinct features are prone to being overlooked in deeper layers of the network. Additionally, the abundance of redundant information in the background poses significant interference to feature extraction, thus increasing the segmentation difficulty. To address this issue, this paper proposes a feature-enhanced interaction network based on DPCN, named MDFI-Net.Specifically, we design a feature enhancement structure, the Deformable-convolutional Pulse Coupling Network (DPCN), to provide an enhanced feature iteration sequence to the segmentation network in a simple and efficient manner. Subsequently, these features will interact within the segmentation network.Extensive experiments were conducted on publicly available retinal vessel segmentation datasets to validate the effectiveness of our network structure. Experimental results of our algorithm show that the detection accuracy of the retinal blood vessel achieves 97.91%, 97.97% and 98.16% across all datasets. Finally, plentiful experimental results also prove that the proposed MDFI-Net achieves segmentation performance superior to state-of-the-art methods on public datasets.
AI-based vascular segmentation is becoming increasingly common in enhancing the screening and treatment of ophthalmic diseases. Deep learning structures based on U-Net have achieved relatively good performance in vascular segmentation. However, small blood vessels and capillaries tend to be lost during segmentation when passed through the traditional U-Net downsampling module. To address this gap, this paper proposes a novel Kalman filter based Linear Deformable Diffusion (KLDD) model for retinal vessel segmentation. Our model employs a diffusion process that iteratively refines the segmentation, leveraging the flexible receptive fields of deformable convolutions in feature extraction modules to adapt to the detailed tubular vascular structures. More specifically, we first employ a feature extractor with linear deformable convolution to capture vascular structure information form the input images. To better optimize the coordinate positions of deformable convolution, we employ the Kalman filter to enhance the perception of vascular structures in linear deformable convolution. Subsequently, the features of the vascular structures extracted are utilized as a conditioning element within a diffusion model by the Cross-Attention Aggregation module (CAAM) and the Channel-wise Soft Attention module (CSAM). These aggregations are designed to enhance the diffusion model's capability to generate vascular structures. Experiments are evaluated on retinal fundus image datasets (DRIVE, CHASE_DB1) as well as the 3mm and 6mm of the OCTA-500 dataset, and the results show that the diffusion model proposed in this paper outperforms other methods.
Deep learning has shown remarkable performance in medical image segmentation. However, despite its promise, deep learning has many challenges in practice due to its inability to effectively transition to unseen domains, caused by the inherent data distribution shift and the lack of manual annotations to guide domain adaptation. To tackle this problem, we present an unsupervised domain adaptation (UDA) method named AdaptDiff that enables a retinal vessel segmentation network trained on fundus photography (FP) to produce satisfactory results on unseen modalities (e.g., OCT-A) without any manual labels. For all our target domains, we first adopt a segmentation model trained on the source domain to create pseudo-labels. With these pseudo-labels, we train a conditional semantic diffusion probabilistic model to represent the target domain distribution. Experimentally, we show that even with low quality pseudo-labels, the diffusion model can still capture the conditional semantic information. Subsequently, we sample on the target domain with binary vessel masks from the source domain to get paired data, i.e., target domain synthetic images conditioned on the binary vessel map. Finally, we fine-tune the pre-trained segmentation network using the synthetic paired data to mitigate the domain gap. We assess the effectiveness of AdaptDiff on seven publicly available datasets across three distinct modalities. Our results demonstrate a significant improvement in segmentation performance across all unseen datasets. Our code is publicly available at https://github.com/DeweiHu/AdaptDiff.
Children often suffer wrist trauma in daily life, while they usually need radiologists to analyze and interpret X-ray images before surgical treatment by surgeons. The development of deep learning has enabled neural networks to serve as computer-assisted diagnosis (CAD) tools to help doctors and experts in medical image diagnostics. Since YOLOv8 model has obtained the satisfactory success in object detection tasks, it has been applied to various fracture detection. This work introduces four variants of Feature Contexts Excitation-YOLOv8 (FCE-YOLOv8) model, each incorporating a different FCE module (i.e., modules of Squeeze-and-Excitation (SE), Global Context (GC), Gather-Excite (GE), and Gaussian Context Transformer (GCT)) to enhance the model performance. Experimental results on GRAZPEDWRI-DX dataset demonstrate that our proposed YOLOv8+GC-M3 model improves the mAP@50 value from 65.78% to 66.32%, outperforming the state-of-the-art (SOTA) model while reducing inference time. Furthermore, our proposed YOLOv8+SE-M3 model achieves the highest mAP@50 value of 67.07%, exceeding the SOTA performance. The implementation of this work is available at https://github.com/RuiyangJu/FCE-YOLOv8.
We introduce VascX models, a comprehensive set of model ensembles for analyzing retinal vasculature from color fundus images (CFIs). Annotated CFIs were aggregated from public datasets . Additional CFIs, mainly from the population-based Rotterdam Study were annotated by graders for arteries and veins at pixel level, resulting in a dataset diverse in patient demographics and imaging conditions. VascX models demonstrated superior segmentation performance across datasets, image quality levels, and anatomic regions when compared to existing, publicly available models, likely due to the increased size and variety of our training set. Important improvements were observed in artery-vein and disc segmentation performance, particularly in segmentations of these structures on CFIs of intermediate quality, common in large cohorts and clinical datasets. Importantly, these improvements translated into significantly more accurate vascular features when we compared features extracted from VascX segmentation masks with features extracted from segmentation masks generated by previous models. With VascX models we provide a robust, ready-to-use set of model ensembles and inference code aimed at simplifying the implementation and enhancing the quality of automated retinal vasculature analyses. The precise vessel parameters generated by the model can serve as starting points for the identification of disease patterns in and outside of the eye.
Effective retinal vessel segmentation requires a sophisticated integration of global contextual awareness and local vessel continuity. To address this challenge, we propose the Graph Capsule Convolution Network (GCC-UNet), which merges capsule convolutions with CNNs to capture both local and global features. The Graph Capsule Convolution operator is specifically designed to enhance the representation of global context, while the Selective Graph Attention Fusion module ensures seamless integration of local and global information. To further improve vessel continuity, we introduce the Bottleneck Graph Attention module, which incorporates Channel-wise and Spatial Graph Attention mechanisms. The Multi-Scale Graph Fusion module adeptly combines features from various scales. Our approach has been rigorously validated through experiments on widely used public datasets, with ablation studies confirming the efficacy of each component. Comparative results highlight GCC-UNet's superior performance over existing methods, setting a new benchmark in retinal vessel segmentation. Notably, this work represents the first integration of vanilla, graph, and capsule convolutional techniques in the domain of medical image segmentation.