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Aug 20

REFUGE2 Challenge: A Treasure Trove for Multi-Dimension Analysis and Evaluation in Glaucoma Screening

With the rapid development of artificial intelligence (AI) in medical image processing, deep learning in color fundus photography (CFP) analysis is also evolving. Although there are some open-source, labeled datasets of CFPs in the ophthalmology community, large-scale datasets for screening only have labels of disease categories, and datasets with annotations of fundus structures are usually small in size. In addition, labeling standards are not uniform across datasets, and there is no clear information on the acquisition device. Here we release a multi-annotation, multi-quality, and multi-device color fundus image dataset for glaucoma analysis on an original challenge -- Retinal Fundus Glaucoma Challenge 2nd Edition (REFUGE2). The REFUGE2 dataset contains 2000 color fundus images with annotations of glaucoma classification, optic disc/cup segmentation, as well as fovea localization. Meanwhile, the REFUGE2 challenge sets three sub-tasks of automatic glaucoma diagnosis and fundus structure analysis and provides an online evaluation framework. Based on the characteristics of multi-device and multi-quality data, some methods with strong generalizations are provided in the challenge to make the predictions more robust. This shows that REFUGE2 brings attention to the characteristics of real-world multi-domain data, bridging the gap between scientific research and clinical application.

UrFound: Towards Universal Retinal Foundation Models via Knowledge-Guided Masked Modeling

Retinal foundation models aim to learn generalizable representations from diverse retinal images, facilitating label-efficient model adaptation across various ophthalmic tasks. Despite their success, current retinal foundation models are generally restricted to a single imaging modality, such as Color Fundus Photography (CFP) or Optical Coherence Tomography (OCT), limiting their versatility. Moreover, these models may struggle to fully leverage expert annotations and overlook the valuable domain knowledge essential for domain-specific representation learning. To overcome these limitations, we introduce UrFound, a retinal foundation model designed to learn universal representations from both multimodal retinal images and domain knowledge. UrFound is equipped with a modality-agnostic image encoder and accepts either CFP or OCT images as inputs. To integrate domain knowledge into representation learning, we encode expert annotation in text supervision and propose a knowledge-guided masked modeling strategy for model pre-training. It involves reconstructing randomly masked patches of retinal images while predicting masked text tokens conditioned on the corresponding retinal image. This approach aligns multimodal images and textual expert annotations within a unified latent space, facilitating generalizable and domain-specific representation learning. Experimental results demonstrate that UrFound exhibits strong generalization ability and data efficiency when adapting to various tasks in retinal image analysis. By training on ~180k retinal images, UrFound significantly outperforms the state-of-the-art retinal foundation model trained on up to 1.6 million unlabelled images across 8 public retinal datasets. Our code and data are available at https://github.com/yukkai/UrFound.

A ResNet is All You Need? Modeling A Strong Baseline for Detecting Referable Diabetic Retinopathy in Fundus Images

Deep learning is currently the state-of-the-art for automated detection of referable diabetic retinopathy (DR) from color fundus photographs (CFP). While the general interest is put on improving results through methodological innovations, it is not clear how good these approaches perform compared to standard deep classification models trained with the appropriate settings. In this paper we propose to model a strong baseline for this task based on a simple and standard ResNet-18 architecture. To this end, we built on top of prior art by training the model with a standard preprocessing strategy but using images from several public sources and an empirically calibrated data augmentation setting. To evaluate its performance, we covered multiple clinically relevant perspectives, including image and patient level DR screening, discriminating responses by input quality and DR grade, assessing model uncertainties and analyzing its results in a qualitative manner. With no other methodological innovation than a carefully designed training, our ResNet model achieved an AUC = 0.955 (0.953 - 0.956) on a combined test set of 61007 test images from different public datasets, which is in line or even better than what other more complex deep learning models reported in the literature. Similar AUC values were obtained in 480 images from two separate in-house databases specially prepared for this study, which emphasize its generalization ability. This confirms that standard networks can still be strong baselines for this task if properly trained.

A Foundation LAnguage-Image model of the Retina (FLAIR): Encoding expert knowledge in text supervision

Foundation vision-language models are currently transforming computer vision, and are on the rise in medical imaging fueled by their very promising generalization capabilities. However, the initial attempts to transfer this new paradigm to medical imaging have shown less impressive performances than those observed in other domains, due to the significant domain shift and the complex, expert domain knowledge inherent to medical-imaging tasks. Motivated by the need for domain-expert foundation models, we present FLAIR, a pre-trained vision-language model for universal retinal fundus image understanding. To this end, we compiled 37 open-access, mostly categorical fundus imaging datasets from various sources, with up to 97 different target conditions and 284,660 images. We integrate the expert's domain knowledge in the form of descriptive textual prompts, during both pre-training and zero-shot inference, enhancing the less-informative categorical supervision of the data. Such a textual expert's knowledge, which we compiled from the relevant clinical literature and community standards, describes the fine-grained features of the pathologies as well as the hierarchies and dependencies between them. We report comprehensive evaluations, which illustrate the benefit of integrating expert knowledge and the strong generalization capabilities of FLAIR under difficult scenarios with domain shifts or unseen categories. When adapted with a lightweight linear probe, FLAIR outperforms fully-trained, dataset-focused models, more so in the few-shot regimes. Interestingly, FLAIR outperforms by a large margin more generalist, larger-scale image-language models, which emphasizes the potential of embedding experts' domain knowledge and the limitations of generalist models in medical imaging.

Constructing Ophthalmic MLLM for Positioning-diagnosis Collaboration Through Clinical Cognitive Chain Reasoning

Multimodal large language models (MLLMs) demonstrate significant potential in the field of medical diagnosis. However, they face critical challenges in specialized domains such as ophthalmology, particularly the fragmentation of annotation granularity and inconsistencies in clinical reasoning logic, which hinder precise cross-modal understanding. This paper introduces FundusExpert, an ophthalmology-specific MLLM with integrated positioning-diagnosis reasoning capabilities, along with FundusGen, a dataset constructed through the intelligent Fundus-Engine system. Fundus-Engine automates localization and leverages MLLM-based semantic expansion to integrate global disease classification, local object detection, and fine-grained feature analysis within a single fundus image. Additionally, by constructing a clinically aligned cognitive chain, it guides the model to generate interpretable reasoning paths. FundusExpert, fine-tuned with instruction data from FundusGen, achieves the best performance in ophthalmic question-answering tasks, surpassing the average accuracy of the 40B MedRegA by 26.6%. It also excels in zero-shot report generation tasks, achieving a clinical consistency of 77.0%, significantly outperforming GPT-4o's 47.6%. Furthermore, we reveal a scaling law between data quality and model capability (L propto N^{0.068}), demonstrating that the cognitive alignment annotations in FundusGen enhance data utilization efficiency. By integrating region-level localization with diagnostic reasoning chains, our work develops a scalable, clinically-aligned MLLM and explores a pathway toward bridging the visual-language gap in specific MLLMs. Our project can be found at https://github.com/MeteorElf/FundusExpert.

VisionUnite: A Vision-Language Foundation Model for Ophthalmology Enhanced with Clinical Knowledge

The need for improved diagnostic methods in ophthalmology is acute, especially in the underdeveloped regions with limited access to specialists and advanced equipment. Therefore, we introduce VisionUnite, a novel vision-language foundation model for ophthalmology enhanced with clinical knowledge. VisionUnite has been pretrained on an extensive dataset comprising 1.24 million image-text pairs, and further refined using our proposed MMFundus dataset, which includes 296,379 high-quality fundus image-text pairs and 889,137 simulated doctor-patient dialogue instances. Our experiments indicate that VisionUnite outperforms existing generative foundation models such as GPT-4V and Gemini Pro. It also demonstrates diagnostic capabilities comparable to junior ophthalmologists. VisionUnite performs well in various clinical scenarios including open-ended multi-disease diagnosis, clinical explanation, and patient interaction, making it a highly versatile tool for initial ophthalmic disease screening. VisionUnite can also serve as an educational aid for junior ophthalmologists, accelerating their acquisition of knowledge regarding both common and underrepresented ophthalmic conditions. VisionUnite represents a significant advancement in ophthalmology, with broad implications for diagnostics, medical education, and understanding of disease mechanisms. The source code is at https://github.com/HUANGLIZI/VisionUnite.

Specialist vision-language models for clinical ophthalmology

Clinicians spend a significant amount of time reviewing medical images and transcribing their findings regarding patient diagnosis, referral and treatment in text form. Vision-language models (VLMs), which automatically interpret images and summarize their findings as text, have enormous potential to alleviate clinical workloads and increase patient access to high-quality medical care. While foundational models have stirred considerable interest in the medical community, it is unclear whether their general capabilities translate to real-world clinical utility. In this work, we show that foundation VLMs markedly underperform compared to practicing ophthalmologists on specialist tasks crucial to the care of patients with age-related macular degeneration (AMD). To address this, we initially identified the essential capabilities required for image-based clinical decision-making, and then developed a curriculum to selectively train VLMs in these skills. The resulting model, RetinaVLM, can be instructed to write reports that significantly outperform those written by leading foundation medical VLMs in disease staging (F1 score of 0.63 vs. 0.11) and patient referral (0.67 vs. 0.39), and approaches the diagnostic performance of junior ophthalmologists (who achieve 0.77 and 0.78 on the respective tasks). Furthermore, in a reader study involving two senior ophthalmologists with up to 32 years of experience, RetinaVLM's reports were found to be similarly correct (78.6% vs. 82.1%) and complete (both 78.6%) as reports written by junior ophthalmologists with up to 10 years of experience. These results demonstrate that our curriculum-based approach provides a blueprint for specializing generalist foundation medical VLMs to handle real-world clinical tasks.

RetFiner: A Vision-Language Refinement Scheme for Retinal Foundation Models

The rise of imaging techniques such as optical coherence tomography (OCT) and advances in deep learning (DL) have enabled clinicians and researchers to streamline retinal disease staging. A popular DL approach is self-supervised learning (SSL), where models learn from vast amounts of unlabeled data, avoiding costly annotation. SSL has allowed the development of foundation models (FMs), large models that can be used for a variety of downstream tasks. However, existing FMs for OCT, trained solely on image data, lack a comprehensive and robust semantic understanding of images, as evidenced by their downstream performance (especially for complex tasks), and thus require supervised fine-tuning (which may be unfeasible) to better adapt to specific applications and populations. To address this, we propose RetFiner, an SSL vision-language refinement scheme that improves the representations of existing FMs and enables their efficient and direct adaptation to specific populations for improved downstream performance. Our method uses a diverse set of training objectives which take advantage of the rich supervisory signal found in textual data. We tested RetFiner on the retinal FMs RETFound, UrFound, and VisionFM, showing significant improvements in linear probing performance on seven highly diverse OCT classification tasks, with an average increase of 5.8, 3.9, and 2.1 percentage points over their baselines, respectively. Our code and model weights are publicly available at https://github.com/ronnief1/RetFiner.

Color Matching Using Hypernetwork-Based Kolmogorov-Arnold Networks

We present cmKAN, a versatile framework for color matching. Given an input image with colors from a source color distribution, our method effectively and accurately maps these colors to match a target color distribution in both supervised and unsupervised settings. Our framework leverages the spline capabilities of Kolmogorov-Arnold Networks (KANs) to model the color matching between source and target distributions. Specifically, we developed a hypernetwork that generates spatially varying weight maps to control the nonlinear splines of a KAN, enabling accurate color matching. As part of this work, we introduce a first large-scale dataset of paired images captured by two distinct cameras and evaluate the efficacy of our and existing methods in matching colors. We evaluated our approach across various color-matching tasks, including: (1) raw-to-raw mapping, where the source color distribution is in one camera's raw color space and the target in another camera's raw space; (2) raw-to-sRGB mapping, where the source color distribution is in a camera's raw space and the target is in the display sRGB space, emulating the color rendering of a camera ISP; and (3) sRGB-to-sRGB mapping, where the goal is to transfer colors from a source sRGB space (e.g., produced by a source camera ISP) to a target sRGB space (e.g., from a different camera ISP). The results show that our method outperforms existing approaches by 37.3% on average for supervised and unsupervised cases while remaining lightweight compared to other methods. The codes, dataset, and pre-trained models are available at: https://github.com/gosha20777/cmKAN

Adaptive Multiscale Retinal Diagnosis: A Hybrid Trio-Model Approach for Comprehensive Fundus Multi-Disease Detection Leveraging Transfer Learning and Siamese Networks

WHO has declared that more than 2.2 billion people worldwide are suffering from visual disorders, such as media haze, glaucoma, and drusen. At least 1 billion of these cases could have been either prevented or successfully treated, yet they remain unaddressed due to poverty, a lack of specialists, inaccurate ocular fundus diagnoses by ophthalmologists, or the presence of a rare disease. To address this, the research has developed the Hybrid Trio-Network Model Algorithm for accurately diagnosing 12 distinct common and rare eye diseases. This algorithm utilized the RFMiD dataset of 3,200 fundus images and the Binary Relevance Method to detect diseases separately, ensuring expandability and avoiding incorrect correlations. Each detector, incorporating finely tuned hyperparameters to optimize performance, consisted of three feature components: A classical transfer learning CNN model, a two-stage CNN model, and a Siamese Network. The diagnosis was made using features extracted through this Trio-Model with Ensembled Machine Learning algorithms. The proposed model achieved an average accuracy of 97% and an AUC score of 0.96. Compared to past benchmark studies, an increase of over 10% in the F1-score was observed for most diseases. Furthermore, using the Siamese Network, the model successfully made predictions in diseases like optic disc pallor, which past studies failed to predict due to low confidence. This diagnostic tool presents a stable, adaptive, cost-effective, efficient, accessible, and fast solution for globalizing early detection of both common and rare diseases.

The Role of AI in Early Detection of Life-Threatening Diseases: A Retinal Imaging Perspective

Retinal imaging has emerged as a powerful, non-invasive modality for detecting and quantifying biomarkers of systemic diseases-ranging from diabetes and hypertension to Alzheimer's disease and cardiovascular disorders but current insights remain dispersed across platforms and specialties. Recent technological advances in optical coherence tomography (OCT/OCTA) and adaptive optics (AO) now deliver ultra-high-resolution scans (down to 5 {\mu}m ) with superior contrast and spatial integration, allowing early identification of microvascular abnormalities and neurodegenerative changes. At the same time, AI-driven and machine learning (ML) algorithms have revolutionized the analysis of large-scale retinal datasets, increasing sensitivity and specificity; for example, deep learning models achieve > 90 \% sensitivity for diabetic retinopathy and AUC = 0.89 for the prediction of cardiovascular risk from fundus photographs. The proliferation of mobile health technologies and telemedicine platforms further extends access, reduces costs, and facilitates community-based screening and longitudinal monitoring. Despite these breakthroughs, translation into routine practice is hindered by heterogeneous imaging protocols, limited external validation of AI models, and integration challenges within clinical workflows. In this review, we systematically synthesize the latest OCT/OCT and AO developments, AI/ML approaches, and mHealth/Tele-ophthalmology initiatives and quantify their diagnostic performance across disease domains. Finally, we propose a roadmap for multicenter protocol standardization, prospective validation trials, and seamless incorporation of retinal screening into primary and specialty care pathways-paving the way for precision prevention, early intervention, and ongoing treatment of life-threatening systemic diseases.

iColoriT: Towards Propagating Local Hint to the Right Region in Interactive Colorization by Leveraging Vision Transformer

Point-interactive image colorization aims to colorize grayscale images when a user provides the colors for specific locations. It is essential for point-interactive colorization methods to appropriately propagate user-provided colors (i.e., user hints) in the entire image to obtain a reasonably colorized image with minimal user effort. However, existing approaches often produce partially colorized results due to the inefficient design of stacking convolutional layers to propagate hints to distant relevant regions. To address this problem, we present iColoriT, a novel point-interactive colorization Vision Transformer capable of propagating user hints to relevant regions, leveraging the global receptive field of Transformers. The self-attention mechanism of Transformers enables iColoriT to selectively colorize relevant regions with only a few local hints. Our approach colorizes images in real-time by utilizing pixel shuffling, an efficient upsampling technique that replaces the decoder architecture. Also, in order to mitigate the artifacts caused by pixel shuffling with large upsampling ratios, we present the local stabilizing layer. Extensive quantitative and qualitative results demonstrate that our approach highly outperforms existing methods for point-interactive colorization, producing accurately colorized images with a user's minimal effort. Official codes are available at https://pmh9960.github.io/research/iColoriT

SEE: See Everything Every Time -- Adaptive Brightness Adjustment for Broad Light Range Images via Events

Event cameras, with a high dynamic range exceeding 120dB, significantly outperform traditional embedded cameras, robustly recording detailed changing information under various lighting conditions, including both low- and high-light situations. However, recent research on utilizing event data has primarily focused on low-light image enhancement, neglecting image enhancement and brightness adjustment across a broader range of lighting conditions, such as normal or high illumination. Based on this, we propose a novel research question: how to employ events to enhance and adaptively adjust the brightness of images captured under broad lighting conditions? To investigate this question, we first collected a new dataset, SEE-600K, consisting of 610,126 images and corresponding events across 202 scenarios, each featuring an average of four lighting conditions with over a 1000-fold variation in illumination. Subsequently, we propose a framework that effectively utilizes events to smoothly adjust image brightness through the use of prompts. Our framework captures color through sensor patterns, uses cross-attention to model events as a brightness dictionary, and adjusts the image's dynamic range to form a broad light-range representation (BLR), which is then decoded at the pixel level based on the brightness prompt. Experimental results demonstrate that our method not only performs well on the low-light enhancement dataset but also shows robust performance on broader light-range image enhancement using the SEE-600K dataset. Additionally, our approach enables pixel-level brightness adjustment, providing flexibility for post-processing and inspiring more imaging applications. The dataset and source code are publicly available at:https://github.com/yunfanLu/SEE.

Image-level Regression for Uncertainty-aware Retinal Image Segmentation

Accurate retinal vessel (RV) segmentation is a crucial step in the quantitative assessment of retinal vasculature, which is needed for the early detection of retinal diseases and other conditions. Numerous studies have been conducted to tackle the problem of segmenting vessels automatically using a pixel-wise classification approach. The common practice of creating ground truth labels is to categorize pixels as foreground and background. This approach is, however, biased, and it ignores the uncertainty of a human annotator when it comes to annotating e.g. thin vessels. In this work, we propose a simple and effective method that casts the RV segmentation task as an image-level regression. For this purpose, we first introduce a novel Segmentation Annotation Uncertainty-Aware (SAUNA) transform, which adds pixel uncertainty to the ground truth using the pixel's closeness to the annotation boundary and vessel thickness. To train our model with soft labels, we generalize the earlier proposed Jaccard metric loss to arbitrary hypercubes for soft Jaccard index (Intersection-over-Union) optimization. Additionally, we employ a stable version of the Focal-L1 loss for pixel-wise regression. We conduct thorough experiments and compare our method to a diverse set of baselines across 5 retinal image datasets. Our empirical results indicate that the integration of the SAUNA transform and these segmentation losses led to significant performance boosts for different segmentation models. Particularly, our methodology enables UNet-like architectures to substantially outperform computational-intensive baselines. Our implementation is available at https://github.com/Oulu-IMEDS/SAUNA.

Beyond the Pixel: a Photometrically Calibrated HDR Dataset for Luminance and Color Prediction

Light plays an important role in human well-being. However, most computer vision tasks treat pixels without considering their relationship to physical luminance. To address this shortcoming, we introduce the Laval Photometric Indoor HDR Dataset, the first large-scale photometrically calibrated dataset of high dynamic range 360{\deg} panoramas. Our key contribution is the calibration of an existing, uncalibrated HDR Dataset. We do so by accurately capturing RAW bracketed exposures simultaneously with a professional photometric measurement device (chroma meter) for multiple scenes across a variety of lighting conditions. Using the resulting measurements, we establish the calibration coefficients to be applied to the HDR images. The resulting dataset is a rich representation of indoor scenes which displays a wide range of illuminance and color, and varied types of light sources. We exploit the dataset to introduce three novel tasks, where: per-pixel luminance, per-pixel color and planar illuminance can be predicted from a single input image. Finally, we also capture another smaller photometric dataset with a commercial 360{\deg} camera, to experiment on generalization across cameras. We are optimistic that the release of our datasets and associated code will spark interest in physically accurate light estimation within the community. Dataset and code are available at https://lvsn.github.io/beyondthepixel/.

Optimizing Illuminant Estimation in Dual-Exposure HDR Imaging

High dynamic range (HDR) imaging involves capturing a series of frames of the same scene, each with different exposure settings, to broaden the dynamic range of light. This can be achieved through burst capturing or using staggered HDR sensors that capture long and short exposures simultaneously in the camera image signal processor (ISP). Within camera ISP pipeline, illuminant estimation is a crucial step aiming to estimate the color of the global illuminant in the scene. This estimation is used in camera ISP white-balance module to remove undesirable color cast in the final image. Despite the multiple frames captured in the HDR pipeline, conventional illuminant estimation methods often rely only on a single frame of the scene. In this paper, we explore leveraging information from frames captured with different exposure times. Specifically, we introduce a simple feature extracted from dual-exposure images to guide illuminant estimators, referred to as the dual-exposure feature (DEF). To validate the efficiency of DEF, we employed two illuminant estimators using the proposed DEF: 1) a multilayer perceptron network (MLP), referred to as exposure-based MLP (EMLP), and 2) a modified version of the convolutional color constancy (CCC) to integrate our DEF, that we call ECCC. Both EMLP and ECCC achieve promising results, in some cases surpassing prior methods that require hundreds of thousands or millions of parameters, with only a few hundred parameters for EMLP and a few thousand parameters for ECCC.

OLIVES Dataset: Ophthalmic Labels for Investigating Visual Eye Semantics

Clinical diagnosis of the eye is performed over multifarious data modalities including scalar clinical labels, vectorized biomarkers, two-dimensional fundus images, and three-dimensional Optical Coherence Tomography (OCT) scans. Clinical practitioners use all available data modalities for diagnosing and treating eye diseases like Diabetic Retinopathy (DR) or Diabetic Macular Edema (DME). Enabling usage of machine learning algorithms within the ophthalmic medical domain requires research into the relationships and interactions between all relevant data over a treatment period. Existing datasets are limited in that they neither provide data nor consider the explicit relationship modeling between the data modalities. In this paper, we introduce the Ophthalmic Labels for Investigating Visual Eye Semantics (OLIVES) dataset that addresses the above limitation. This is the first OCT and near-IR fundus dataset that includes clinical labels, biomarker labels, disease labels, and time-series patient treatment information from associated clinical trials. The dataset consists of 1268 near-IR fundus images each with at least 49 OCT scans, and 16 biomarkers, along with 4 clinical labels and a disease diagnosis of DR or DME. In total, there are 96 eyes' data averaged over a period of at least two years with each eye treated for an average of 66 weeks and 7 injections. We benchmark the utility of OLIVES dataset for ophthalmic data as well as provide benchmarks and concrete research directions for core and emerging machine learning paradigms within medical image analysis.

UltraFusion: Ultra High Dynamic Imaging using Exposure Fusion

Capturing high dynamic range (HDR) scenes is one of the most important issues in camera design. Majority of cameras use exposure fusion technique, which fuses images captured by different exposure levels, to increase dynamic range. However, this approach can only handle images with limited exposure difference, normally 3-4 stops. When applying to very high dynamic scenes where a large exposure difference is required, this approach often fails due to incorrect alignment or inconsistent lighting between inputs, or tone mapping artifacts. In this work, we propose UltraFusion, the first exposure fusion technique that can merge input with 9 stops differences. The key idea is that we model the exposure fusion as a guided inpainting problem, where the under-exposed image is used as a guidance to fill the missing information of over-exposed highlight in the over-exposed region. Using under-exposed image as a soft guidance, instead of a hard constrain, our model is robust to potential alignment issue or lighting variations. Moreover, utilizing the image prior of the generative model, our model also generates natural tone mapping, even for very high-dynamic range scene. Our approach outperforms HDR-Transformer on latest HDR benchmarks. Moreover, to test its performance in ultra high dynamic range scene, we capture a new real-world exposure fusion benchmark, UltraFusion Dataset, with exposure difference up to 9 stops, and experiments show that \model~can generate beautiful and high-quality fusion results under various scenarios. An online demo is provided at https://openimaginglab.github.io/UltraFusion/.

UniRGB-IR: A Unified Framework for RGB-Infrared Semantic Tasks via Adapter Tuning

Semantic analysis on visible (RGB) and infrared (IR) images has gained attention for its ability to be more accurate and robust under low-illumination and complex weather conditions. Due to the lack of pre-trained foundation models on the large-scale infrared image datasets, existing methods prefer to design task-specific frameworks and directly fine-tune them with pre-trained foundation models on their RGB-IR semantic relevance datasets, which results in poor scalability and limited generalization. In this work, we propose a general and efficient framework called UniRGB-IR to unify RGB-IR semantic tasks, in which a novel adapter is developed to efficiently introduce richer RGB-IR features into the pre-trained RGB-based foundation model. Specifically, our framework consists of a RGB-based foundation model, a Multi-modal Feature Pool (MFP) module and a Supplementary Feature Injector (SFI) module. The MFP and SFI modules cooperate with each other as an adapter to effectively complement the RGB-based features with the rich RGB-IR features. During training process, we freeze the entire foundation model to inherit prior knowledge and only optimize the proposed adapter. Furthermore, to verify the effectiveness of our framework, we utilize the vanilla vision transformer (ViT-Base) as the pre-trained foundation model to perform extensive experiments. Experimental results on various RGB-IR downstream tasks demonstrate that our method can achieve state-of-the-art performance. The source code and results are available at https://github.com/PoTsui99/UniRGB-IR.git.

Eye Fairness: A Large-Scale 3D Imaging Dataset for Equitable Eye Diseases Screening and Fair Identity Scaling

Fairness or equity in machine learning is profoundly important for societal well-being, but limited public datasets hinder its progress, especially in the area of medicine. It is undeniable that fairness in medicine is one of the most important areas for fairness learning's applications. Currently, no large-scale public medical datasets with 3D imaging data for fairness learning are available, while 3D imaging data in modern clinics are standard tests for disease diagnosis. In addition, existing medical fairness datasets are actually repurposed datasets, and therefore they typically have limited demographic identity attributes with at most three identity attributes of age, gender, and race for fairness modeling. To address this gap, we introduce our Eye Fairness dataset with 30,000 subjects (Harvard-EF) covering three major eye diseases including age-related macular degeneration, diabetic retinopathy, and glaucoma affecting 380 million patients globally. Our Harvard-EF dataset includes both 2D fundus photos and 3D optical coherence tomography scans with six demographic identity attributes including age, gender, race, ethnicity, preferred language, and marital status. We also propose a fair identity scaling (FIS) approach combining group and individual scaling together to improve model fairness. Our FIS approach is compared with various state-of-the-art fairness learning methods with superior performance in the racial, gender, and ethnicity fairness tasks with 2D and 3D imaging data, which demonstrate the utilities of our Harvard-EF dataset for fairness learning. To facilitate fairness comparisons between different models, we propose performance-scaled disparity measures, which can be used to compare model fairness accounting for overall performance levels. The dataset and code are publicly accessible via https://ophai.hms.harvard.edu/datasets/harvard-ef30k.

4KAgent: Agentic Any Image to 4K Super-Resolution

We present 4KAgent, a unified agentic super-resolution generalist system designed to universally upscale any image to 4K resolution (and even higher, if applied iteratively). Our system can transform images from extremely low resolutions with severe degradations, for example, highly distorted inputs at 256x256, into crystal-clear, photorealistic 4K outputs. 4KAgent comprises three core components: (1) Profiling, a module that customizes the 4KAgent pipeline based on bespoke use cases; (2) A Perception Agent, which leverages vision-language models alongside image quality assessment experts to analyze the input image and make a tailored restoration plan; and (3) A Restoration Agent, which executes the plan, following a recursive execution-reflection paradigm, guided by a quality-driven mixture-of-expert policy to select the optimal output for each step. Additionally, 4KAgent embeds a specialized face restoration pipeline, significantly enhancing facial details in portrait and selfie photos. We rigorously evaluate our 4KAgent across 11 distinct task categories encompassing a total of 26 diverse benchmarks, setting new state-of-the-art on a broad spectrum of imaging domains. Our evaluations cover natural images, portrait photos, AI-generated content, satellite imagery, fluorescence microscopy, and medical imaging like fundoscopy, ultrasound, and X-ray, demonstrating superior performance in terms of both perceptual (e.g., NIQE, MUSIQ) and fidelity (e.g., PSNR) metrics. By establishing a novel agentic paradigm for low-level vision tasks, we aim to catalyze broader interest and innovation within vision-centric autonomous agents across diverse research communities. We will release all the code, models, and results at: https://4kagent.github.io.

EndoPBR: Material and Lighting Estimation for Photorealistic Surgical Simulations via Physically-based Rendering

The lack of labeled datasets in 3D vision for surgical scenes inhibits the development of robust 3D reconstruction algorithms in the medical domain. Despite the popularity of Neural Radiance Fields and 3D Gaussian Splatting in the general computer vision community, these systems have yet to find consistent success in surgical scenes due to challenges such as non-stationary lighting and non-Lambertian surfaces. As a result, the need for labeled surgical datasets continues to grow. In this work, we introduce a differentiable rendering framework for material and lighting estimation from endoscopic images and known geometry. Compared to previous approaches that model lighting and material jointly as radiance, we explicitly disentangle these scene properties for robust and photorealistic novel view synthesis. To disambiguate the training process, we formulate domain-specific properties inherent in surgical scenes. Specifically, we model the scene lighting as a simple spotlight and material properties as a bidirectional reflectance distribution function, parameterized by a neural network. By grounding color predictions in the rendering equation, we can generate photorealistic images at arbitrary camera poses. We evaluate our method with various sequences from the Colonoscopy 3D Video Dataset and show that our method produces competitive novel view synthesis results compared with other approaches. Furthermore, we demonstrate that synthetic data can be used to develop 3D vision algorithms by finetuning a depth estimation model with our rendered outputs. Overall, we see that the depth estimation performance is on par with fine-tuning with the original real images.

HDRT: Infrared Capture for HDR Imaging

Capturing real world lighting is a long standing challenge in imaging and most practical methods acquire High Dynamic Range (HDR) images by either fusing multiple exposures, or boosting the dynamic range of Standard Dynamic Range (SDR) images. Multiple exposure capture is problematic as it requires longer capture times which can often lead to ghosting problems. The main alternative, inverse tone mapping is an ill-defined problem that is especially challenging as single captured exposures usually contain clipped and quantized values, and are therefore missing substantial amounts of content. To alleviate this, we propose a new approach, High Dynamic Range Thermal (HDRT), for HDR acquisition using a separate, commonly available, thermal infrared (IR) sensor. We propose a novel deep neural method (HDRTNet) which combines IR and SDR content to generate HDR images. HDRTNet learns to exploit IR features linked to the RGB image and the IR-specific parameters are subsequently used in a dual branch method that fuses features at shallow layers. This produces an HDR image that is significantly superior to that generated using naive fusion approaches. To validate our method, we have created the first HDR and thermal dataset, and performed extensive experiments comparing HDRTNet with the state-of-the-art. We show substantial quantitative and qualitative quality improvements on both over- and under-exposed images, showing that our approach is robust to capturing in multiple different lighting conditions.

Harvard Glaucoma Detection and Progression: A Multimodal Multitask Dataset and Generalization-Reinforced Semi-Supervised Learning

Glaucoma is the number one cause of irreversible blindness globally. A major challenge for accurate glaucoma detection and progression forecasting is the bottleneck of limited labeled patients with the state-of-the-art (SOTA) 3D retinal imaging data of optical coherence tomography (OCT). To address the data scarcity issue, this paper proposes two solutions. First, we develop a novel generalization-reinforced semi-supervised learning (SSL) model called pseudo supervisor to optimally utilize unlabeled data. Compared with SOTA models, the proposed pseudo supervisor optimizes the policy of predicting pseudo labels with unlabeled samples to improve empirical generalization. Our pseudo supervisor model is evaluated with two clinical tasks consisting of glaucoma detection and progression forecasting. The progression forecasting task is evaluated both unimodally and multimodally. Our pseudo supervisor model demonstrates superior performance than SOTA SSL comparison models. Moreover, our model also achieves the best results on the publicly available LAG fundus dataset. Second, we introduce the Harvard Glaucoma Detection and Progression (Harvard-GDP) Dataset, a multimodal multitask dataset that includes data from 1,000 patients with OCT imaging data, as well as labels for glaucoma detection and progression. This is the largest glaucoma detection dataset with 3D OCT imaging data and the first glaucoma progression forecasting dataset that is publicly available. Detailed sex and racial analysis are provided, which can be used by interested researchers for fairness learning studies. Our released dataset is benchmarked with several SOTA supervised CNN and transformer deep learning models. The dataset and code are made publicly available via https://ophai.hms.harvard.edu/datasets/harvard-gdp1000.

MedImageInsight: An Open-Source Embedding Model for General Domain Medical Imaging

In this work, we present MedImageInsight, an open-source medical imaging embedding model. MedImageInsight is trained on medical images with associated text and labels across a diverse collection of domains, including X-Ray, CT, MRI, dermoscopy, OCT, fundus photography, ultrasound, histopathology, and mammography. Rigorous evaluations demonstrate MedImageInsight's ability to achieve state-of-the-art (SOTA) or human expert level performance across classification, image-image search, and fine-tuning tasks. Specifically, on public datasets, MedImageInsight achieves SOTA in CT 3D medical image retrieval, as well as SOTA in disease classification and search for chest X-ray, dermatology, and OCT imaging. Furthermore, MedImageInsight achieves human expert performance in bone age estimation (on both public and partner data), as well as AUC above 0.9 in most other domains. When paired with a text decoder, MedImageInsight achieves near SOTA level single image report findings generation with less than 10\% the parameters of other models. Compared to fine-tuning GPT-4o with only MIMIC-CXR data for the same task, MedImageInsight outperforms in clinical metrics, but underperforms on lexical metrics where GPT-4o sets a new SOTA. Importantly for regulatory purposes, MedImageInsight can generate ROC curves, adjust sensitivity and specificity based on clinical need, and provide evidence-based decision support through image-image search (which can also enable retrieval augmented generation). In an independent clinical evaluation of image-image search in chest X-ray, MedImageInsight outperformed every other publicly available foundation model evaluated by large margins (over 6 points AUC), and significantly outperformed other models in terms of AI fairness (across age and gender). We hope releasing MedImageInsight will help enhance collective progress in medical imaging AI research and development.

ERDES: A Benchmark Video Dataset for Retinal Detachment and Macular Status Classification in Ocular Ultrasound

Retinal detachment (RD) is a vision-threatening condition that requires timely intervention to preserve vision. Macular involvement -- whether the macula is still intact (macula-intact) or detached (macula-detached) -- is the key determinant of visual outcomes and treatment urgency. Point-of-care ultrasound (POCUS) offers a fast, non-invasive, cost-effective, and accessible imaging modality widely used in diverse clinical settings to detect RD. However, ultrasound image interpretation is limited by a lack of expertise among healthcare providers, especially in resource-limited settings. Deep learning offers the potential to automate ultrasound-based assessment of RD. However, there are no ML ultrasound algorithms currently available for clinical use to detect RD and no prior research has been done on assessing macular status using ultrasound in RD cases -- an essential distinction for surgical prioritization. Moreover, no public dataset currently supports macular-based RD classification using ultrasound video clips. We introduce Eye Retinal DEtachment ultraSound, ERDES, the first open-access dataset of ocular ultrasound clips labeled for (i) presence of retinal detachment and (ii) macula-intact versus macula-detached status. The dataset is intended to facilitate the development and evaluation of machine learning models for detecting retinal detachment. We also provide baseline benchmarks using multiple spatiotemporal convolutional neural network (CNN) architectures. All clips, labels, and training code are publicly available at https://osupcvlab.github.io/ERDES/.

Name Your Colour For the Task: Artificially Discover Colour Naming via Colour Quantisation Transformer

The long-standing theory that a colour-naming system evolves under dual pressure of efficient communication and perceptual mechanism is supported by more and more linguistic studies, including analysing four decades of diachronic data from the Nafaanra language. This inspires us to explore whether machine learning could evolve and discover a similar colour-naming system via optimising the communication efficiency represented by high-level recognition performance. Here, we propose a novel colour quantisation transformer, CQFormer, that quantises colour space while maintaining the accuracy of machine recognition on the quantised images. Given an RGB image, Annotation Branch maps it into an index map before generating the quantised image with a colour palette; meanwhile the Palette Branch utilises a key-point detection way to find proper colours in the palette among the whole colour space. By interacting with colour annotation, CQFormer is able to balance both the machine vision accuracy and colour perceptual structure such as distinct and stable colour distribution for discovered colour system. Very interestingly, we even observe the consistent evolution pattern between our artificial colour system and basic colour terms across human languages. Besides, our colour quantisation method also offers an efficient quantisation method that effectively compresses the image storage while maintaining high performance in high-level recognition tasks such as classification and detection. Extensive experiments demonstrate the superior performance of our method with extremely low bit-rate colours, showing potential to integrate into quantisation network to quantities from image to network activation. The source code is available at https://github.com/ryeocthiv/CQFormer

Contribution-based Low-Rank Adaptation with Pre-training Model for Real Image Restoration

Recently, pre-trained model and efficient parameter tuning have achieved remarkable success in natural language processing and high-level computer vision with the aid of masked modeling and prompt tuning. In low-level computer vision, however, there have been limited investigations on pre-trained models and even efficient fine-tuning strategy has not yet been explored despite its importance and benefit in various real-world tasks such as alleviating memory inflation issue when integrating new tasks on AI edge devices. Here, we propose a novel efficient parameter tuning approach dubbed contribution-based low-rank adaptation (CoLoRA) for multiple image restorations along with effective pre-training method with random order degradations (PROD). Unlike prior arts that tune all network parameters, our CoLoRA effectively fine-tunes small amount of parameters by leveraging LoRA (low-rank adaptation) for each new vision task with our contribution-based method to adaptively determine layer by layer capacity for that task to yield comparable performance to full tuning. Furthermore, our PROD strategy allows to extend the capability of pre-trained models with improved performance as well as robustness to bridge synthetic pre-training and real-world fine-tuning. Our CoLoRA with PROD has demonstrated its superior performance in various image restoration tasks across diverse degradation types on both synthetic and real-world datasets for known and novel tasks.

PVBM: A Python Vasculature Biomarker Toolbox Based On Retinal Blood Vessel Segmentation

Introduction: Blood vessels can be non-invasively visualized from a digital fundus image (DFI). Several studies have shown an association between cardiovascular risk and vascular features obtained from DFI. Recent advances in computer vision and image segmentation enable automatising DFI blood vessel segmentation. There is a need for a resource that can automatically compute digital vasculature biomarkers (VBM) from these segmented DFI. Methods: In this paper, we introduce a Python Vasculature BioMarker toolbox, denoted PVBM. A total of 11 VBMs were implemented. In particular, we introduce new algorithmic methods to estimate tortuosity and branching angles. Using PVBM, and as a proof of usability, we analyze geometric vascular differences between glaucomatous patients and healthy controls. Results: We built a fully automated vasculature biomarker toolbox based on DFI segmentations and provided a proof of usability to characterize the vascular changes in glaucoma. For arterioles and venules, all biomarkers were significant and lower in glaucoma patients compared to healthy controls except for tortuosity, venular singularity length and venular branching angles. Conclusion: We have automated the computation of 11 VBMs from retinal blood vessel segmentation. The PVBM toolbox is made open source under a GNU GPL 3 license and is available on physiozoo.com (following publication).

Improving Lens Flare Removal with General Purpose Pipeline and Multiple Light Sources Recovery

When taking images against strong light sources, the resulting images often contain heterogeneous flare artifacts. These artifacts can importantly affect image visual quality and downstream computer vision tasks. While collecting real data pairs of flare-corrupted/flare-free images for training flare removal models is challenging, current methods utilize the direct-add approach to synthesize data. However, these methods do not consider automatic exposure and tone mapping in image signal processing pipeline (ISP), leading to the limited generalization capability of deep models training using such data. Besides, existing methods struggle to handle multiple light sources due to the different sizes, shapes and illuminance of various light sources. In this paper, we propose a solution to improve the performance of lens flare removal by revisiting the ISP and remodeling the principle of automatic exposure in the synthesis pipeline and design a more reliable light sources recovery strategy. The new pipeline approaches realistic imaging by discriminating the local and global illumination through convex combination, avoiding global illumination shifting and local over-saturation. Our strategy for recovering multiple light sources convexly averages the input and output of the neural network based on illuminance levels, thereby avoiding the need for a hard threshold in identifying light sources. We also contribute a new flare removal testing dataset containing the flare-corrupted images captured by ten types of consumer electronics. The dataset facilitates the verification of the generalization capability of flare removal methods. Extensive experiments show that our solution can effectively improve the performance of lens flare removal and push the frontier toward more general situations.

OCTCube-M: A 3D multimodal optical coherence tomography foundation model for retinal and systemic diseases with cross-cohort and cross-device validation

We present OCTCube-M, a 3D OCT-based multi-modal foundation model for jointly analyzing OCT and en face images. OCTCube-M first developed OCTCube, a 3D foundation model pre-trained on 26,685 3D OCT volumes encompassing 1.62 million 2D OCT images. It then exploits a novel multi-modal contrastive learning framework COEP to integrate other retinal imaging modalities, such as fundus autofluorescence and infrared retinal imaging, into OCTCube, efficiently extending it into multi-modal foundation models. OCTCube achieves best performance on predicting 8 retinal diseases, demonstrating strong generalizability on cross-cohort, cross-device and cross-modality prediction. OCTCube can also predict cross-organ nodule malignancy (CT) and low cardiac ejection fraction as well as systemic diseases, such as diabetes and hypertension, revealing its wide applicability beyond retinal diseases. We further develop OCTCube-IR using COEP with 26,685 OCT and IR image pairs. OCTCube-IR can accurately retrieve between OCT and IR images, allowing joint analysis between 3D and 2D retinal imaging modalities. Finally, we trained a tri-modal foundation model OCTCube-EF from 4 million 2D OCT images and 400K en face retinal images. OCTCube-EF attains the best performance on predicting the growth rate of geographic atrophy (GA) across datasets collected from 6 multi-center global trials conducted in 23 countries. This improvement is statistically equivalent to running a clinical trial with more than double the size of the original study. Our analysis based on another retrospective case study reveals OCTCube-EF's ability to avoid false positive Phase-III results according to its accurate treatment effect estimation on the Phase-II results. In sum, OCTCube-M is a 3D multi-modal foundation model framework that integrates OCT and other retinal imaging modalities revealing substantial diagnostic and prognostic benefits.

Quantifying the Poor Purity and Completeness of Morphological Samples Selected by Galaxy Colour

The galaxy population is strongly bimodal in both colour and morphology, and the two measures correlate strongly, with most blue galaxies being late-types (spirals) and most early-types, typically ellipticals, being red. This observation has led to the use of colour as a convenient selection criteria to make samples which are then labelled by morphology. Such use of colour as a proxy for morphology results in necessarily impure and incomplete samples. In this paper, we make use of the morphological labels produced by Galaxy Zoo to measure how incomplete and impure such samples are, considering optical (ugriz), NUV and NIR (JHK) bands. The best single colour optical selection is found using a threshold of g-r = 0.742, but this still results in a sample where only 56% of red galaxies are smooth and 56% of smooth galaxies are red. Use of the NUV gives some improvement over purely optical bands, particularly for late-types, but still results in low purity/completeness for early-types. No significant improvement is found by adding NIR bands. With any two bands, including NUV, a sample of early-types with greater than two-thirds purity cannot be constructed. Advances in quantitative galaxy morphologies have made colour-morphology proxy selections largely unnecessary going forward; where such assumptions are still required, we recommend studies carefully consider the implications of sample incompleteness/impurity.