Daily Papers

Purpose: This study introduces the first adaptation of RETFound for joint optic disc (OD) and optic cup (OC) segmentation. RETFound is a well-known foundation model developed for fundus camera and optical coherence tomography images, which has shown promising performance in disease diagnosis. Methods: We propose FunduSegmenter, a model integrating a series of novel modules with RETFound, including a Pre-adapter, a Decoder, a Post-adapter, skip connections with Convolutional Block Attention Module and a Vision Transformer block adapter. The model is evaluated on a proprietary dataset, GoDARTS, and four public datasets, IDRiD, Drishti-GS, RIM-ONE-r3, and REFUGE, through internal verification, external verification and domain generalization experiments. Results: An average Dice similarity coefficient of 90.51% was achieved in internal verification, which outperformed all baselines, some substantially (nnU-Net: 82.91%; DUNet: 89.17%; TransUNet: 87.91%). In all external verification experiments, the average results were about 3% higher than those of the best baseline, and our model was also competitive in domain generalization. Conclusions: This study explored the potential of the latent general representations learned by RETFound for OD and OC segmentation in fundus camera images. Our FunduSegmenter generally outperformed state-of-the-art baseline methods. The proposed modules are general and can be extended to fine-tuning other foundation models. Translational Relevance: The model shows strong stability and generalization on both in-distribution and out-of-distribution data, providing stable OD and OC segmentation. This is an essential step for many automated tasks, from setting the accurate retinal coordinate to biomarker discovery. The code and trained weights are available at: https://github.com/JusticeZzy/FunduSegmenter.

Redundancies and correlations in the responses of sensory neurons seem to waste neural resources but can carry cues about structured stimuli and may help the brain to correct for response errors. To assess how the retina negotiates this tradeoff, we measured simultaneous responses from populations of ganglion cells presented with natural and artificial stimuli that varied greatly in correlation structure. We found that pairwise correlations in the retinal output remained similar across stimuli with widely different spatio-temporal correlations including white noise and natural movies. Meanwhile, purely spatial correlations tended to increase correlations in the retinal response. Responding to more correlated stimuli, ganglion cells had faster temporal kernels and tended to have stronger surrounds. These properties of individual cells, along with gain changes that opposed changes in effective contrast at the ganglion cell input, largely explained the similarity of pairwise correlations across stimuli where receptive field measurements were possible.

We propose a novel framework for retinal feature point alignment, designed for learning cross-modality features to enhance matching and registration across multi-modality retinal images. Our model draws on the success of previous learning-based feature detection and description methods. To better leverage unlabeled data and constrain the model to reproduce relevant keypoints, we integrate a keypoint-based segmentation task. It is trained in a self-supervised manner by enforcing segmentation consistency between different augmentations of the same image. By incorporating a keypoint augmented self-supervised layer, we achieve robust feature extraction across modalities. Extensive evaluation on two public datasets and one in-house dataset demonstrates significant improvements in performance for modality-agnostic retinal feature alignment. Our code and model weights are publicly available at https://github.com/MedICL-VU/RetinaIPA.

From a falcon detecting prey to humans recognizing faces, many species exhibit extraordinary abilities in rapid visual localization and classification. These are made possible by a specialized retinal region called the fovea, which provides high acuity at the center of vision while maintaining lower resolution in the periphery. This distinctive spatial organization, preserved along the early visual pathway through retinotopic mapping, is fundamental to biological vision, yet remains largely unexplored in machine learning. Our study investigates how incorporating foveated retinotopy may benefit deep convolutional neural networks (CNNs) in image classification tasks. By implementing a foveated retinotopic transformation in the input layer of standard ResNet models and re-training them, we maintain comparable classification accuracy while enhancing the network's robustness to scale and rotational perturbations. Although this architectural modification introduces increased sensitivity to fixation point shifts, we demonstrate how this apparent limitation becomes advantageous: variations in classification probabilities across different gaze positions serve as effective indicators for object localization. Our findings suggest that foveated retinotopic mapping encodes implicit knowledge about visual object geometry, offering an efficient solution to the visual search problem - a capability crucial for many living species.

Optical Coherence Tomography Angiography (OCTA) and its derived en-face projections provide high-resolution visualization of the retinal and choroidal vasculature, which is critical for the rapid and accurate diagnosis of retinal diseases. However, acquiring high-quality OCTA images is challenging due to motion sensitivity and the high costs associated with software modifications for conventional OCT devices. Moreover, current deep learning methods for OCT-to-OCTA translation often overlook the vascular differences across retinal layers and struggle to reconstruct the intricate, dense vascular details necessary for reliable diagnosis. To overcome these limitations, we propose XOCT, a novel deep learning framework that integrates Cross-Dimensional Supervision (CDS) with a Multi-Scale Feature Fusion (MSFF) network for layer-aware vascular reconstruction. Our CDS module leverages 2D layer-wise en-face projections, generated via segmentation-weighted z-axis averaging, as supervisory signals to compel the network to learn distinct representations for each retinal layer through fine-grained, targeted guidance. Meanwhile, the MSFF module enhances vessel delineation through multi-scale feature extraction combined with a channel reweighting strategy, effectively capturing vascular details at multiple spatial scales. Our experiments on the OCTA-500 dataset demonstrate XOCT's improvements, especially for the en-face projections which are significant for clinical evaluation of retinal pathologies, underscoring its potential to enhance OCTA accessibility, reliability, and diagnostic value for ophthalmic disease detection and monitoring. The code is available at https://github.com/uci-cbcl/XOCT.

Effectively representing medical images, especially retinal images, presents a considerable challenge due to variations in appearance, size, and contextual information of pathological signs called lesions. Precise discrimination of these lesions is crucial for diagnosing vision-threatening issues such as diabetic retinopathy. While visual attention-based neural networks have been introduced to learn spatial context and channel correlations from retinal images, they often fall short in capturing localized lesion context. Addressing this limitation, we propose a novel attention mechanism called Guided Context Gating, an unique approach that integrates Context Formulation, Channel Correlation, and Guided Gating to learn global context, spatial correlations, and localized lesion context. Our qualitative evaluation against existing attention mechanisms emphasize the superiority of Guided Context Gating in terms of explainability. Notably, experiments on the Zenodo-DR-7 dataset reveal a substantial 2.63% accuracy boost over advanced attention mechanisms & an impressive 6.53% improvement over the state-of-the-art Vision Transformer for assessing the severity grade of retinopathy, even with imbalanced and limited training samples for each class.

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.

Retinal imaging is fast, non-invasive, and widely available, offering quantifiable structural and vascular signals for ophthalmic and systemic health assessment. This accessibility creates an opportunity to study how quantitative retinal phenotypes relate to ocular and systemic diseases. However, such analyses remain difficult at scale due to the limited availability of public multi-label datasets and the lack of a unified segmentation-to-quantification pipeline. We present RetSAM, a general retinal segmentation and quantification framework for fundus imaging. It delivers robust multi-target segmentation and standardized biomarker extraction, supporting downstream ophthalmologic studies and oculomics correlation analyses. Trained on over 200,000 fundus images, RetSAM supports three task categories and segments five anatomical structures, four retinal phenotypic patterns, and more than 20 distinct lesion types. It converts these segmentation results into over 30 standardized biomarkers that capture structural morphology, vascular geometry, and degenerative changes. Trained with a multi-stage strategy using both private and public fundus data, RetSAM achieves superior segmentation performance on 17 public datasets. It improves on prior best methods by 3.9 percentage points in DSC on average, with up to 15 percentage points on challenging multi-task benchmarks, and generalizes well across diverse populations, imaging devices, and clinical settings. The resulting biomarkers enable systematic correlation analyses across major ophthalmic diseases, including diabetic retinopathy, age-related macular degeneration, glaucoma, and pathologic myopia. Together, RetSAM transforms fundus images into standardized, interpretable quantitative phenotypes, enabling large-scale ophthalmic research and translation.

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/.

Vital to primary visual processing, retinal circuitry shows many similar structures across a very broad array of species, both vertebrate and non-vertebrate, especially functional components such as lateral inhibition. This surprisingly conservative pattern raises a question of how evolution leads to it, and whether there is any alternative that can also prompt helpful preprocessing. Here we design a method using genetic algorithm that, with many degrees of freedom, leads to architectures whose functions are similar to biological retina, as well as effective alternatives that are different in structures and functions. We compare this model to natural evolution and discuss how our framework can come into goal-driven search and sustainable enhancement of neural network models in machine learning.

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.

The scarcity of high-quality, labelled retinal imaging data, which presents a significant challenge in the development of machine learning models for ophthalmology, hinders progress in the field. Existing methods for synthesising Colour Fundus Photographs (CFPs) largely rely on predefined disease labels, which restricts their ability to generate images that reflect fine-grained anatomical variations, subtle disease stages, and diverse pathological features beyond coarse class categories. To overcome these challenges, we first introduce an innovative pipeline that creates a large-scale, captioned retinal dataset comprising 1.4 million entries, called RetinaLogos-1400k. Specifically, RetinaLogos-1400k uses the visual language model(VLM) to describe retinal conditions and key structures, such as optic disc configuration, vascular distribution, nerve fibre layers, and pathological features. Building on this dataset, we employ a novel three-step training framework, RetinaLogos, which enables fine-grained semantic control over retinal images and accurately captures different stages of disease progression, subtle anatomical variations, and specific lesion types. Through extensive experiments, our method demonstrates superior performance across multiple datasets, with 62.07% of text-driven synthetic CFPs indistinguishable from real ones by ophthalmologists. Moreover, the synthetic data improves accuracy by 5%-10% in diabetic retinopathy grading and glaucoma detection. Codes are available at https://github.com/uni-medical/retina-text2cfp.

Optical coherence tomography (OCT) is a non-invasive imaging technique with extensive clinical applications in ophthalmology. OCT enables the visualization of the retinal layers, playing a vital role in the early detection and monitoring of retinal diseases. OCT uses the principle of light wave interference to create detailed images of the retinal microstructures, making it a valuable tool for diagnosing ocular conditions. This work presents an open-access OCT dataset (OCTDL) comprising over 1600 high-resolution OCT images labeled according to disease group and retinal pathology. The dataset consists of OCT records of patients with Age-related Macular Degeneration (AMD), Diabetic Macular Edema (DME), Epiretinal Membrane (ERM), Retinal Artery Occlusion (RAO), Retinal Vein Occlusion (RVO), and Vitreomacular Interface Disease (VID). The images were acquired with an Optovue Avanti RTVue XR using raster scanning protocols with dynamic scan length and image resolution. Each retinal b-scan was acquired by centering on the fovea and interpreted and cataloged by an experienced retinal specialist. In this work, we applied Deep Learning classification techniques to this new open-access dataset.

The retina is the only part of the human body in which blood vessels can be accessed non-invasively using imaging techniques such as digital fundus images (DFI). The spatial distribution of the retinal microvasculature may change with cardiovascular diseases and thus the eyes may be regarded as a window to our hearts. Computerized segmentation of the retinal arterioles and venules (A/V) is essential for automated microvasculature analysis. Using active learning, we created a new DFI dataset containing 240 crowd-sourced manual A/V segmentations performed by fifteen medical students and reviewed by an ophthalmologist, and developed LUNet, a novel deep learning architecture for high resolution A/V segmentation. LUNet architecture includes a double dilated convolutional block that aims to enhance the receptive field of the model and reduce its parameter count. Furthermore, LUNet has a long tail that operates at high resolution to refine the segmentation. The custom loss function emphasizes the continuity of the blood vessels. LUNet is shown to significantly outperform two state-of-the-art segmentation algorithms on the local test set as well as on four external test sets simulating distribution shifts across ethnicity, comorbidities, and annotators. We make the newly created dataset open access (upon publication).

Optical coherence tomography (OCT) based measurements of retinal layer thickness, such as the retinal nerve fibre layer (RNFL) and the ganglion cell with inner plexiform layer (GCIPL) are commonly used for the diagnosis and monitoring of glaucoma. Previously, machine learning techniques have utilized segmentation-based imaging features such as the peripapillary RNFL thickness and the cup-to-disc ratio. Here, we propose a deep learning technique that classifies eyes as healthy or glaucomatous directly from raw, unsegmented OCT volumes of the optic nerve head (ONH) using a 3D Convolutional Neural Network (CNN). We compared the accuracy of this technique with various feature-based machine learning algorithms and demonstrated the superiority of the proposed deep learning based method. Logistic regression was found to be the best performing classical machine learning technique with an AUC of 0.89. In direct comparison, the deep learning approach achieved a substantially higher AUC of 0.94 with the additional advantage of providing insight into which regions of an OCT volume are important for glaucoma detection. Computing Class Activation Maps (CAM), we found that the CNN identified neuroretinal rim and optic disc cupping as well as the lamina cribrosa (LC) and its surrounding areas as the regions significantly associated with the glaucoma classification. These regions anatomically correspond to the well established and commonly used clinical markers for glaucoma diagnosis such as increased cup volume, cup diameter, and neuroretinal rim thinning at the superior and inferior segments.

The retinal vasculature provides important clues in the diagnosis and monitoring of systemic diseases including hypertension and diabetes. The microvascular system is of primary involvement in such conditions, and the retina is the only anatomical site where the microvasculature can be directly observed. The objective assessment of retinal vessels has long been considered a surrogate biomarker for systemic vascular diseases, and with recent advancements in retinal imaging and computer vision technologies, this topic has become the subject of renewed attention. In this paper, we present a novel dataset, dubbed RAVIR, for the semantic segmentation of Retinal Arteries and Veins in Infrared Reflectance (IR) imaging. It enables the creation of deep learning-based models that distinguish extracted vessel type without extensive post-processing. We propose a novel deep learning-based methodology, denoted as SegRAVIR, for the semantic segmentation of retinal arteries and veins and the quantitative measurement of the widths of segmented vessels. Our extensive experiments validate the effectiveness of SegRAVIR and demonstrate its superior performance in comparison to state-of-the-art models. Additionally, we propose a knowledge distillation framework for the domain adaptation of RAVIR pretrained networks on color images. We demonstrate that our pretraining procedure yields new state-of-the-art benchmarks on the DRIVE, STARE, and CHASE_DB1 datasets. Dataset link: https://ravirdataset.github.io/data/

This investigation reports on the results of convolutional neural networks developed for the recently introduced PathologicAL Myopia (PALM) dataset, which consists of 1200 fundus images. We propose a new Optic Nerve Head (ONH)-based prediction enhancement for the segmentation of atrophy and fovea. Models trained with 400 available training images achieved an AUC of 0.9867 for pathological myopia classification, and a Euclidean distance of 58.27 pixels on the fovea localization task, evaluated on a test set of 400 images. Dice and F1 metrics for semantic segmentation of lesions scored 0.9303 and 0.9869 on optic disc, 0.8001 and 0.9135 on retinal atrophy, and 0.8073 and 0.7059 on retinal detachment, respectively. Our work was acknowledged with an award in the context of the "PathologicAL Myopia detection from retinal images" challenge held during the IEEE International Symposium on Biomedical Imaging (April 2019). Considering that (pathological) myopia cases are often identified as false positives and negatives in classification systems for glaucoma, we envision that the current work could aid in future research to discriminate between glaucomatous and highly-myopic eyes, complemented by the localization and segmentation of landmarks such as fovea, optic disc and atrophy.

Cortical visual prostheses aim to restore sight by electrically stimulating neurons in early visual cortex (V1). With the emergence of high-density and flexible neural interfaces, electrode placement within three-dimensional cortex has become a critical surgical planning problem. Existing strategies emphasize visual field coverage and anatomical heuristics but do not directly optimize predicted perceptual outcomes under safety constraints. We present a percept-aware framework for surgical planning of cortical visual prostheses that formulates electrode placement as a constrained optimization problem in anatomical space. Electrode coordinates are treated as learnable parameters and optimized end-to-end using a differentiable forward model of prosthetic vision. The objective minimizes task-level perceptual error while incorporating vascular avoidance and gray matter feasibility constraints. Evaluated on simulated reading and natural image tasks using realistic folded cortical geometry (FreeSurfer fsaverage), percept-aware optimization consistently improves reconstruction fidelity relative to coverage-based placement strategies. Importantly, vascular safety constraints eliminate margin violations while preserving perceptual performance. The framework further enables co-optimization of multi-electrode thread configurations under fixed insertion budgets. These results demonstrate how differentiable percept models can inform anatomically grounded, safety-aware computer-assisted planning for cortical neural interfaces and provide a foundation for optimizing next-generation visual prostheses.

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.

Automated segmentation of retinal optical coherence tomography (OCT) images has become an important recent direction in machine learning for medical applications. We hypothesize that the anatomic structure of layers and their high-frequency variation in OCT images make retinal OCT a fitting choice for extracting spectral-domain features and combining them with spatial domain features. In this work, we present Upsilon-Net, an architecture that combines the frequency domain features with the image domain to improve the segmentation performance of OCT images. The results of this work demonstrate that the introduction of two branches, one for spectral and one for spatial domain features, brings a very significant improvement in fluid segmentation performance and allows outperformance as compared to the well-known U-Net model. Our improvement was 13% on the fluid segmentation dice score and 1.9% on the average dice score. Finally, removing selected frequency ranges in the spectral domain demonstrates the impact of these features on the fluid segmentation outperformance.

The retina offers a noninvasive window into neurodegenerative disease, capturing subtle structural patterns associated with a risk of future cognitive decline. Vision-language alignment frameworks such as REVEAL have shown that pairing retinal fundus images with structured clinical risk narratives improves early prediction of Alzheimer's disease (AD). A key design choice in these approaches is the use of phenotypic grouping, where individuals with similar risk profiles are treated as multi-positive pairs during contrastive learning. However, existing methods operationalize phenotypic similarity as a discrete construct, relying on hard group assignments that impose rigid supervision and decouple group formation from representation learning. We propose a continuous formulation of phenotypic structure within contrastive learning. Rather than assigning samples to fixed clusters, we model inter-subject similarity as a differentiable weighting function derived from intra-modality embedding similarities in both retinal images and risk profiles. These weights define soft multi-positive relationships through a continuous aggregation operator, enabling graded supervision that reflects the spectrum nature of disease risk. We further introduce a soft-target contrastive objective that jointly learns cross-modal alignment and phenotypic structure in an end-to-end manner. Evaluated on UK Biobank retinal imaging data for incident AD prediction, the proposed framework consistently outperforms discrete group-based contrastive learning and standard vision-language baselines. By treating phenotypic similarity as a learnable, continuous signal rather than a fixed grouping rule, our approach provides a principled and robust foundation for population-scale neurodegenerative risk modeling from multi-modal retinal and clinical data.

Complete orthogonal predictive coordinates do not by themselves bind a latent direction to a named intervention. We present a mathematical and synthetic audit motivated by vascular device-vessel suitcordance. Capacity-matched least-squares predictors were exactly equivalent under complete fixed output transforms, whereas an anchor-only observer recovered interpretations only within the span of known perturbation signatures. Six three-dimensional configurations across 64 seeds gave a maximum paired prediction discrepancy of 6.7e-15 but a median untransported edit error of 1.513. Coordinate transport removed that error. Noisy and weak anchors constrained calibration stability, and changing the representation basis required recalibration or verified transport. Across 256 additional fits in dimensions 3-24, prediction equivalence persisted within 4.0e-15. We then evaluated nine deliberate runnable fault classes across 64 seeds. All 576 faulty executions completed, but each violated at least one reconstruction, prediction, delivered-edit or scope contract; all 320 valid control records passed. Repeating a faulty implementation gave exact self-agreement despite error against the separately computed simulator expectation. For one omitted-direction defect, probe coverage followed its analytic law, and rank-aware abstention protected unsupported interpretations. Scalar-noise experiments exposed both missed weak faults and excessive rejection under narrow relative tolerances. These controls provide an executable separation of prediction, semantic support and scientific acceptance. They are synthetic numerical audits, not clinical validation, neural JEPA-Anything replication, agent learning or patient treatment-effect estimation.

Measuring retinal fluid from optical coherence tomography (OCT) drives treatment decisions in macular disease, but manual annotation is slow and segmentation models trained on one scanner degrade on another. We present an attention-guided TransUNet that segments three fluid types across four independent OCT sources, combining a domain-adaptive normalisation scheme with an uncertainty estimate that flags unreliable pixels. The model reaches a mean fluid Dice of 0.78, and -- most usefully for clinicians -- its uncertainty is 1.34x higher exactly where expert graders disagree (p<10^-4), turning a raw segmentation map into an actionable clinical triage signal.

Existing approaches to 3D scene understanding in Vision-Language Models (VLMs) either rely on complex, model-specific geometry encoders or large training budgets in pursuit of spatial reasoning. Instead, OneCanvas aggregates patch features from all views onto a single equirectangular panoramic canvas. Namely, each patch is unprojected to a 3D world coordinate using its depth and camera pose, then placed on the canvas at the continuous longitude and latitude of that point as seen from the canvas origin, with no rasterization or aggregation across overlapping views. A 3D position embedding of the patch's metric coordinates is added to its feature, restoring the depth lost when collapsing the world position to an angular canvas coordinate. Patches from all frames thus share one spatial coordinate system with no fusion or major architectural modifications of the backbone. The pretrained VLM consumes this representation as if it were an ordinary image. Because the canvas can be centered on any pose of interest, the same representation directly supports situated reasoning from a specific viewpoint, a common requirement in robotics and embodied AI. Thanks to this representation, we can also introduce a spatial pretraining curriculum: by procedurally placing patch features of objects, drawn from real images, at chosen 3D world positions on an otherwise empty canvas, we generate on-the-fly supervision spanning a broad range of spatial reasoning tasks, with answer distributions controlled to reduce spatial reasoning shortcuts. OneCanvas achieves state-of-the-art accuracy on SQA3D and VSI-Bench, and generalizes to out-of-distribution data on SPBench, using an order of magnitude less training compute than the strongest competing methods.

Clinical decision-making relies heavily on understanding relative positions of anatomical structures and anomalies. Therefore, for Vision-Language Models (VLMs) to be applicable in clinical practice, the ability to accurately determine relative positions on medical images is a fundamental prerequisite. Despite its importance, this capability remains highly underexplored. To address this gap, we evaluate the ability of state-of-the-art VLMs, GPT-4o, Llama3.2, Pixtral, and JanusPro, and find that all models fail at this fundamental task. Inspired by successful approaches in computer vision, we investigate whether visual prompts, such as alphanumeric or colored markers placed on anatomical structures, can enhance performance. While these markers provide moderate improvements, results remain significantly lower on medical images compared to observations made on natural images. Our evaluations suggest that, in medical imaging, VLMs rely more on prior anatomical knowledge than on actual image content for answering relative position questions, often leading to incorrect conclusions. To facilitate further research in this area, we introduce the MIRP , Medical Imaging Relative Positioning, benchmark dataset, designed to systematically evaluate the capability to identify relative positions in medical images.

With the advent of smartphone indirect ophthalmoscopy, teleophthalmology - the use of specialist ophthalmology assets at a distance from the patient - has experienced a breakthrough, promising enormous benefits especially for healthcare in distant, inaccessible or opthalmologically underserved areas, where specialists are either unavailable or too few in number. However, accurate teleophthalmology requires high-quality ophthalmoscopic imagery. This paper considers three feature families - statistical metrics, gradient-based metrics and wavelet transform coefficient derived indicators - as possible metrics to identify unsharp or blurry images. By using standard machine learning techniques, the suitability of these features for image quality assessment is confirmed, albeit on a rather small data set. With the increased availability and decreasing cost of digital ophthalmoscopy on one hand and the increased prevalence of diabetic retinopathy worldwide on the other, creating tools that can determine whether an image is likely to be diagnostically suitable can play a significant role in accelerating and streamlining the teleophthalmology process. This paper highlights the need for more research in this area, including the compilation of a diverse database of ophthalmoscopic imagery, annotated with quality markers, to train the Point of Acquisition error detection algorithms of the future.

Retinal foundation models have significantly advanced retinal image analysis by leveraging self-supervised learning to reduce dependence on labeled data while achieving strong generalization. Many recent approaches enhance retinal image understanding using report supervision, but obtaining clinical reports is often costly and challenging. In contrast, metadata (e.g., age, gender) is widely available and serves as a valuable resource for analyzing disease progression. To effectively incorporate patient-specific information, we propose PRETI, a retinal foundation model that integrates metadata-aware learning with robust self-supervised representation learning. We introduce Learnable Metadata Embedding (LME), which dynamically refines metadata representations. Additionally, we construct patient-level data pairs, associating images from the same individual to improve robustness against non-clinical variations. To further optimize retinal image representation, we propose Retina-Aware Adaptive Masking (RAAM), a strategy that selectively applies masking within the retinal region and dynamically adjusts the masking ratio during training. PRETI captures both global structures and fine-grained pathological details, resulting in superior diagnostic performance. Extensive experiments demonstrate that PRETI achieves state-of-the-art results across diverse diseases and biomarker predictions using in-house and public data, indicating the importance of metadata-guided foundation models in retinal disease analysis. Our code and pretrained model are available at https://github.com/MICV-yonsei/PRETI

Optical Coherence Tomography (OCT) is essential for diagnosing conditions such as glaucoma, diabetic retinopathy, and age-related macular degeneration. Accurate retinal layer segmentation enables quantitative biomarkers critical for clinical decision-making, but manual segmentation is time-consuming and variable, while conventional deep learning models often lack interpretability. This work proposes an improved SegNet-based deep learning framework for automated and interpretable retinal layer segmentation. Architectural innovations, including modified pooling strategies, enhance feature extraction from noisy OCT images, while a hybrid loss function combining categorical cross-entropy and Dice loss improves performance for thin and imbalanced retinal layers. Gradient-weighted Class Activation Mapping (Grad-CAM) is integrated to provide visual explanations, allowing clinical validation of model decisions. Trained and validated on the Duke OCT dataset, the framework achieved 95.77% validation accuracy, a Dice coefficient of 0.9446, and a Jaccard Index (IoU) of 0.8951. Class-wise results confirmed robust performance across most layers, with challenges remaining for thinner boundaries. Grad-CAM visualizations highlighted anatomically relevant regions, aligning segmentation with clinical biomarkers and improving transparency. By combining architectural improvements, a customized hybrid loss, and explainable AI, this study delivers a high-performing SegNet-based framework that bridges the gap between accuracy and interpretability. The approach offers strong potential for standardizing OCT analysis, enhancing diagnostic efficiency, and fostering clinical trust in AI-driven ophthalmic tools.

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.

Diabetic Retinopathy (DR), induced by diabetes, poses a significant risk of visual impairment. Accurate and effective grading of DR aids in the treatment of this condition. Yet existing models experience notable performance degradation on unseen domains due to domain shifts. Previous methods address this issue by simulating domain style through simple visual transformation and mitigating domain noise via learning robust representations. However, domain shifts encompass more than image styles. They overlook biases caused by implicit factors such as ethnicity, age, and diagnostic criteria. In our work, we propose a novel framework where representations of paired data from different domains are decoupled into semantic features and domain noise. The resulting augmented representation comprises original retinal semantics and domain noise from other domains, aiming to generate enhanced representations aligned with real-world clinical needs, incorporating rich information from diverse domains. Subsequently, to improve the robustness of the decoupled representations, class and domain prototypes are employed to interpolate the disentangled representations while data-aware weights are designed to focus on rare classes and domains. Finally, we devise a robust pixel-level semantic alignment loss to align retinal semantics decoupled from features, maintaining a balance between intra-class diversity and dense class features. Experimental results on multiple benchmarks demonstrate the effectiveness of our method on unseen domains. The code implementations are accessible on https://github.com/richard-peng-xia/DECO.

Feed-forward 3D foundation models reconstruct perspective scenes in one pass. Satellite photogrammetry needs a different product, one that domain adaptation alone does not deliver: dense surface height in an absolute geodetic frame under non-central rational polynomial cameras (RPCs). Perspective-pretrained features are not reliably observable along RPC height rays, absolute elevation carries a low-order height--datum gauge exchangeable with sensor bias to first order, and monocular and multi-view cues fail in different regions. treats all three. Lightweight ray-consistent adapters make a frozen backbone matchable along native RPC rays. An explicit datum mechanism separates relief from absolute level and is equivariant to the vertical origin by construction, so one trained model serves zero-, one-, and sparse-control inference. Calibrated inverse-variance fusion combines the two relief streams. , our absolute-frame benchmark of eighteen systems across in-domain, cross-dataset, and cross-city tiers, scores absolute placement without registration or test-reference leakage. On 26 held-out US3D tiles, attains 2.99\,m absolute MAE at 91.9% coverage, improves completeness-aware accuracy by 46.4 points over the strongest compliant feed-forward baseline, remains the most accurate such system under both transfer shifts, and runs in 24\,s model-forward time per tile. Code and models will be released at https://github.com/HIT-SIRS/GeoRay

Deep remote photoplethysmography (rPPG) attains sub-bpm heart-rate error on frontal, stationary faces yet degrades sharply under head pose: on MMPD, the state-of-the-art FactorizePhys backbone's MAE grows 1.60times from frontal (|yaw|{<}15^circ) to large-yaw (|yaw|{geq}45^circ) frames. We argue that pose is a coordinate-structural nuisance rather than a data-augmentation problem: in image coordinates the same pixel maps to different anatomy at different poses, blocking three priors otherwise natural for rPPG, namely the dichromatic reflection model, pulse-phase invariance across skin regions, and the POS/CHROM chromaticity projection, each of which presumes a stable anatomy-to-pixel mapping. We introduce CanonicalPhys, which prepends a differentiable four-point homography that fixes four facial anchors at canonical positions; in this canonical frame the three priors become expressible as a per-pixel Lambertian weight, a cross-ROI temporal consistency loss, and knowledge distillation from windowed POS, none of which adds trainable parameters over the backbone. At an identical parameter count, CanonicalPhys reduces MMPD's frontal-to-large-yaw MAE degradation from 1.60times to 1.33times and flattens the mild-yaw bin from 1.32times to 1.07times (across CanonicalPhys variants), with matched cross-dataset MAE reductions of up to 32% on pose-rich targets. Code: https://github.com/infraface/CanonicalPhys

Given a target dataset, such as faces with eyeglasses, and a background dataset, such as faces without, contrastive analysis separates salient factors specific to the target from common content shared by both. We aim for salient representations that capture target-specific detail in each image, such as the shape, color, and position of the glasses, so that they reveal subtypes without subtype labels and guide the generation of new examples of a discovered subtype, even one with no name or text description. We introduce SAGE, which learns both factors directly in the high-dimensional spatial latent of a frozen representation autoencoder and conditions a diffusion transformer on the learned salient representation of a reference image. On Digits-ImageNet and FFHQ eyeglasses, SAGE combines high-fidelity reconstruction (rFID below 2) with unsupervised subtype discovery, recovering the digits better than baselines (probe accuracy 0.950 vs.\ at most 0.281) and revealing eyewear types, finer sunglasses styles, and mislabeled images; salient-conditioned generation raises Digits-ImageNet subtype accuracy over the unfactorized latent (90.5% vs.\ 27.7%) and diversity on both datasets. On retinal OCT, SAGE's salient space separates three diseases using only normal/disease labels.

The morphological attributes of retinal vessels, such as length, width, tortuosity and branching pattern and angles, play an important role in diagnosis, screening, treatment, and evaluation of various cardiovascular and ophthalmologic diseases such as diabetes, hypertension and arteriosclerosis. The crucial step before extracting these morphological characteristics of retinal vessels from retinal fundus images is vessel segmentation. In this work, we propose a method for retinal vessel segmentation based on fully convolutional networks. Thousands of patches are extracted from each retinal image and then fed into the network, and data argumentation is applied by rotating extracted patches. Two architectures of fully convolutional networks, U-Net and LadderNet, are used for vessel segmentation. The performance of our method is evaluated on three public datasets: DRIVE, STARE, and CHASE\_DB1. Experimental results of our method show superior performance compared to recent state-of-the-art methods.

Visual grounding is a central challenge for GUI agents, requiring an instruction to be mapped to a target within a crowded screenshot. Coordinate generation with single-point supervision reduces a spatially extended target to one position, despite the presence of many valid click locations. Region-based patch scoring alleviates this ambiguity, but its spatial decisions remain tied to visual-token footprints that may span the target, neighboring controls, and background. To address these limitations, we propose Seg2Click, which reformulates GUI grounding as executable-region prediction: identifying where a click can validly execute the given instruction. Using bounding-box supervision, Seg2Click predicts an executable-region mask and computes the final click point through a deterministic rule. This formulation captures the spatial extent of valid click locations and enables finer localization beyond the visual-token grid, making it well suited to small, densely arranged controls without requiring a verifier or zoom-in pass. Experiments across five backbone configurations from two model families demonstrate the effectiveness of Seg2Click. Seg2Click-9B achieves 92.06\%, 94.10\%, and 55.22\% on ScreenSpot, ScreenSpot-v2, and ScreenSpot-Pro, respectively, while matched-backbone comparisons show improvements over both coordinate generation and patch-based grounding. Code will be available at https://github.com/jcwang0602/Seg2Click.

Identifying cell types and understanding their functional properties is crucial for unraveling the mechanisms underlying perception and cognition. In the retina, functional types can be identified by carefully selected stimuli, but this requires expert domain knowledge and biases the procedure towards previously known cell types. In the visual cortex, it is still unknown what functional types exist and how to identify them. Thus, for unbiased identification of the functional cell types in retina and visual cortex, new approaches are needed. Here we propose an optimization-based clustering approach using deep predictive models to obtain functional clusters of neurons using Most Discriminative Stimuli (MDS). Our approach alternates between stimulus optimization with cluster reassignment akin to an expectation-maximization algorithm. The algorithm recovers functional clusters in mouse retina, marmoset retina and macaque visual area V4. This demonstrates that our approach can successfully find discriminative stimuli across species, stages of the visual system and recording techniques. The resulting most discriminative stimuli can be used to assign functional cell types fast and on the fly, without the need to train complex predictive models or show a large natural scene dataset, paving the way for experiments that were previously limited by experimental time. Crucially, MDS are interpretable: they visualize the distinctive stimulus patterns that most unambiguously identify a specific type of neuron.

Many keypoint detection and description methods have been proposed for image matching or registration. While these methods demonstrate promising performance for single-modality image matching, they often struggle with multimodal data because the descriptors trained on single-modality data tend to lack robustness against the non-linear variations present in multimodal data. Extending such methods to multimodal image matching often requires well-aligned multimodal data to learn modality-invariant descriptors. However, acquiring such data is often costly and impractical in many real-world scenarios. To address this challenge, we propose a modality-invariant feature learning network (MIFNet) to compute modality-invariant features for keypoint descriptions in multimodal image matching using only single-modality training data. Specifically, we propose a novel latent feature aggregation module and a cumulative hybrid aggregation module to enhance the base keypoint descriptors trained on single-modality data by leveraging pre-trained features from Stable Diffusion models. We validate our method with recent keypoint detection and description methods in three multimodal retinal image datasets (CF-FA, CF-OCT, EMA-OCTA) and two remote sensing datasets (Optical-SAR and Optical-NIR). Extensive experiments demonstrate that the proposed MIFNet is able to learn modality-invariant feature for multimodal image matching without accessing the targeted modality and has good zero-shot generalization ability. The source code will be made publicly available.

Diabetic retinopathy (DR) is a leading cause of vision loss in working-age adults. While screening reduces the risk of blindness, traditional imaging is often costly and inaccessible. Artificial intelligence (AI) algorithms present a scalable diagnostic solution, but concerns regarding fairness and generalization persist. This work evaluates the fairness and performance of image-trained models in DR prediction, as well as the impact of disentanglement as a bias mitigation technique, using the diverse mBRSET fundus dataset. Three models, ConvNeXt V2, DINOv2, and Swin V2, were trained on macula images to predict DR and sensitive attributes (SAs) (e.g., age and gender/sex). Fairness was assessed between subgroups of SAs, and disentanglement was applied to reduce bias. All models achieved high DR prediction performance in diagnosing (up to 94% AUROC) and could reasonably predict age and gender/sex (91% and 77% AUROC, respectively). Fairness assessment suggests disparities, such as a 10% AUROC gap between age groups in DINOv2. Disentangling SAs from DR prediction had varying results, depending on the model selected. Disentanglement improved DINOv2 performance (2% AUROC gain), but led to performance drops in ConvNeXt V2 and Swin V2 (7% and 3%, respectively). These findings highlight the complexity of disentangling fine-grained features in fundus imaging and emphasize the importance of fairness in medical imaging AI to ensure equitable and reliable healthcare solutions.

The systemic, metabolic, lifestyle factors have established associations with Alzheimer's Disease (AD) through epidemiologic and AD-specific biomarker studies. Whether colored fundus photography (CFP) contains retinal structural signatures corresponding to these AD-related risk domains remains unclear. To determine whether deep learning (DL) models can predict 12 AD-related risk factors from CFP and to characterize the retinal structures underlying these predictions, thereby assessing whether CFP reflects pathways to AD vulnerability. Using 62,876 CFPs from 44,501 unique participants from the UK Biobank, DL models were trained to predict 12 factors linked to AD incidence: 6 categorical (sex, smoking, sleeplessness, economic status, alcohol use, depression) and 6 continuous (age, age at completing education, BMI, systolic, diastolic blood pressure, HbA1c). Model performance, model saliency, and saliency-derived scores (CAM-Score) were evaluated and compared to retinal morphometry. The scores were also compared between incident-AD cases (average 8.55 years before onset) and matched controls. Performance of DL ranged from AUROC= 0.5654-0.9480 for categorical and R2=-0.0291-0.7620 for continuous factors, outperforming most of the morphometry-machine learning models. Saliency-based score consistently highlighted biologically meaningful regions, particularly the optic nerve head and retinal vasculature. It also aligned with present morphometric variations. Several saliency-based scores differed significantly between incident AD and matched controls, suggesting potential overlap between retinal correlates of risk factors and preclinical AD-associated changes. CFP encodes retinal signatures linked to AD risk factors. Although not diagnostic, DL-derived retinal representations may uncover biologically meaningful risk-related structural changes mirroring the potential AD vulnerability.

Equirectangular projection (ERP) is the standard representation for 360^circ imagery, and robust dense feature matching on ERP underpins panoramic stereo, view synthesis, and omnidirectional SLAM. Dense matchers trained on flat images degrade systematically on ERP because the chart introduces three coupled distortions -- topological, metric, and area -- that standard coarse matching and visibility estimation do not explicitly model. We show that correcting the three distortions at the coarse-stage interfaces where they arise -- pairwise distortions in attention, per-pixel distortion in covisibility gating -- improves PCK@1^circ from 0.229 to 0.275 on Matterport3D under a fixed coarse scaffold, with the refiner architecture unchanged -- our central result. Concretely, SCCM (Spherically Consistent Coarse Matching) augments a chart-naive cross-attention/dual-softmax coarse matcher with two sphere-derived priors: Spherical Positional Attention (SPA) pairs a yaw-periodic RoPE (topology) with a tangent-plane bias (metric), and Area-Aware Covisibility (AAC) applies a pre-sigmoid log-area correction (area). The chart-naive scaffold serves as a controlled reference, separating the scaffold-replacement effect from the spherical-prior effect. Instantiated in the RoMa V1 framework with the same frozen encoder, refiner architecture, and loss, SCCM also outperforms the ERP-native EDM (0.163) and an ERP-retrained RoMa V1 (0.198) under a unified ERP dense matching protocol, while perspective-trained matchers largely fail on ERP. It further transfers zero-shot to Stanford2D3D and, when trained on outdoor Holo360D, leads there as well.

Color fundus photography and Optical Coherence Tomography (OCT) are the two most cost-effective tools for glaucoma screening. Both two modalities of images have prominent biomarkers to indicate glaucoma suspected. Clinically, it is often recommended to take both of the screenings for a more accurate and reliable diagnosis. However, although numerous algorithms are proposed based on fundus images or OCT volumes in computer-aided diagnosis, there are still few methods leveraging both of the modalities for the glaucoma assessment. Inspired by the success of Retinal Fundus Glaucoma Challenge (REFUGE) we held previously, we set up the Glaucoma grAding from Multi-Modality imAges (GAMMA) Challenge to encourage the development of fundus \& OCT-based glaucoma grading. The primary task of the challenge is to grade glaucoma from both the 2D fundus images and 3D OCT scanning volumes. As part of GAMMA, we have publicly released a glaucoma annotated dataset with both 2D fundus color photography and 3D OCT volumes, which is the first multi-modality dataset for glaucoma grading. In addition, an evaluation framework is also established to evaluate the performance of the submitted methods. During the challenge, 1272 results were submitted, and finally, top-10 teams were selected to the final stage. We analysis their results and summarize their methods in the paper. Since all these teams submitted their source code in the challenge, a detailed ablation study is also conducted to verify the effectiveness of the particular modules proposed. We find many of the proposed techniques are practical for the clinical diagnosis of glaucoma. As the first in-depth study of fundus \& OCT multi-modality glaucoma grading, we believe the GAMMA Challenge will be an essential starting point for future research.

Recent self-supervised learning (SSL) models trained on human-like egocentric visual inputs substantially underperform on image recognition tasks compared to humans. These models train on raw, uniform visual inputs collected from head-mounted cameras. This is different from humans, as the anatomical structure of the retina and visual cortex relatively amplifies the central visual information, i.e. around humans' gaze location. This selective amplification in humans likely aids in forming object-centered visual representations. Here, we investigate whether focusing on central visual information boosts egocentric visual object learning. We simulate 5-months of egocentric visual experience using the large-scale Ego4D dataset and generate gaze locations with a human gaze prediction model. To account for the importance of central vision in humans, we crop the visual area around the gaze location. Finally, we train a time-based SSL model on these modified inputs. Our experiments demonstrate that focusing on central vision leads to better object-centered representations. Our analysis shows that the SSL model leverages the temporal dynamics of the gaze movements to build stronger visual representations. Overall, our work marks a significant step toward bio-inspired learning of visual representations.

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.

Diabetic retinopathy (DR) is a growing health problem worldwide and is a leading cause of visual impairment and blindness, especially among working people aged 20-65. Its incidence is increasing along with the number of diabetes cases, and it is more common in developed countries than in developing countries. Recent research in the field of diabetic retinopathy diagnosis is using advanced technologies, such as analysis of images obtained by ophthalmoscopy. Automatic methods for analyzing eye images based on neural networks, deep learning and image analysis algorithms can improve the efficiency of diagnosis. This paper describes an automatic DR diagnosis method that includes processing and analysis of ophthalmoscopic images of the eye. It uses morphological algorithms to identify the optic disc and lesions characteristic of DR, such as microaneurysms, hemorrhages and exudates. Automated DR diagnosis has the potential to improve the efficiency of early detection of this disease and contribute to reducing the number of cases of diabetes-related visual impairment. The final step was to create an application with a graphical user interface that allowed retinal images taken at cooperating ophthalmology offices to be uploaded to the server. These images were then analyzed using a developed algorithm to make a diagnosis.

Scene coordinate regression (SCR) methods are a family of visual localization methods that directly regress 2D-3D matches for camera pose estimation. They are effective in small-scale scenes but face significant challenges in large-scale scenes that are further amplified in the absence of ground truth 3D point clouds for supervision. Here, the model can only rely on reprojection constraints and needs to implicitly triangulate the points. The challenges stem from a fundamental dilemma: The network has to be invariant to observations of the same landmark at different viewpoints and lighting conditions, etc., but at the same time discriminate unrelated but similar observations. The latter becomes more relevant and severe in larger scenes. In this work, we tackle this problem by introducing the concept of co-visibility to the network. We propose GLACE, which integrates pre-trained global and local encodings and enables SCR to scale to large scenes with only a single small-sized network. Specifically, we propose a novel feature diffusion technique that implicitly groups the reprojection constraints with co-visibility and avoids overfitting to trivial solutions. Additionally, our position decoder parameterizes the output positions for large-scale scenes more effectively. Without using 3D models or depth maps for supervision, our method achieves state-of-the-art results on large-scale scenes with a low-map-size model. On Cambridge landmarks, with a single model, we achieve 17% lower median position error than Poker, the ensemble variant of the state-of-the-art SCR method ACE. Code is available at: https://github.com/cvg/glace.

Optical coherence tomography (OCT) and scanning laser ophthalmoscopy (SLO) of the eye has become essential to ophthalmology and the emerging field of oculomics, thus requiring a need for transparent, reproducible, and rapid analysis of this data for clinical research and the wider research community. Here, we introduce OCTolyzer, the first open-source toolkit for retinochoroidal analysis in OCT/SLO data. It features two analysis suites for OCT and SLO data, facilitating deep learning-based anatomical segmentation and feature extraction of the cross-sectional retinal and choroidal layers and en face retinal vessels. We describe OCTolyzer and evaluate the reproducibility of its OCT choroid analysis. At the population level, metrics for choroid region thickness were highly reproducible, with a mean absolute error (MAE)/Pearson correlation for macular volume choroid thickness (CT) of 6.7mum/0.99, macular B-scan CT of 11.6mum/0.99, and peripapillary CT of 5.0mum/0.99. Macular choroid vascular index (CVI) also showed strong reproducibility, with MAE/Pearson for volume CVI yielding 0.0271/0.97 and B-scan CVI 0.0130/0.91. At the eye level, measurement noise for regional and vessel metrics was below 5% and 20% of the population's variability, respectively. Outliers were caused by poor-quality B-scans with thick choroids and invisible choroid-sclera boundary. Processing times on a laptop CPU were under three seconds for macular/peripapillary B-scans and 85 seconds for volume scans. OCTolyzer can convert OCT/SLO data into reproducible and clinically meaningful retinochoroidal features and will improve the standardisation of ocular measurements in OCT/SLO image analysis, requiring no specialised training or proprietary software to be used. OCTolyzer is freely available here: https://github.com/jaburke166/OCTolyzer.

The reflective nature of the human eye is an underappreciated source of information about what the world around us looks like. By imaging the eyes of a moving person, we can collect multiple views of a scene outside the camera's direct line of sight through the reflections in the eyes. In this paper, we reconstruct a 3D scene beyond the camera's line of sight using portrait images containing eye reflections. This task is challenging due to 1) the difficulty of accurately estimating eye poses and 2) the entangled appearance of the eye iris and the scene reflections. Our method jointly refines the cornea poses, the radiance field depicting the scene, and the observer's eye iris texture. We further propose a simple regularization prior on the iris texture pattern to improve reconstruction quality. Through various experiments on synthetic and real-world captures featuring people with varied eye colors, we demonstrate the feasibility of our approach to recover 3D scenes using eye reflections.

As a promising fashion for visual localization, scene coordinate regression (SCR) has seen tremendous progress in the past decade. Most recent methods usually adopt neural networks to learn the mapping from image pixels to 3D scene coordinates, which requires a vast amount of annotated training data. We propose to leverage Neural Radiance Fields (NeRF) to generate training samples for SCR. Despite NeRF's efficiency in rendering, many of the rendered data are polluted by artifacts or only contain minimal information gain, which can hinder the regression accuracy or bring unnecessary computational costs with redundant data. These challenges are addressed in three folds in this paper: (1) A NeRF is designed to separately predict uncertainties for the rendered color and depth images, which reveal data reliability at the pixel level. (2) SCR is formulated as deep evidential learning with epistemic uncertainty, which is used to evaluate information gain and scene coordinate quality. (3) Based on the three arts of uncertainties, a novel view selection policy is formed that significantly improves data efficiency. Experiments on public datasets demonstrate that our method could select the samples that bring the most information gain and promote the performance with the highest efficiency.

Vision-language models hold considerable promise for ophthalmology, but their development depends on large-scale, high-quality image-text datasets that remain scarce. We present PubMed-Ophtha, a hierarchical dataset of 102,023 ophthalmological image-caption pairs extracted from 15,842 open-access articles in PubMed Central. Unlike existing datasets, figures are extracted directly from article PDFs at full resolution and decomposed into their constituent panels, panel identifiers, and individual images. Each image is annotated with its imaging modality -- color fundus photography, optical coherence tomography, retinal imaging, or other -- and a mark status indicating the presence of annotation marks such as arrows. Figure captions are split into panel-level subcaptions using a two-step LLM approach, achieving a mean average sentence BLEU score of 0.913 on human-annotated data. Panel and image detection models reach a [email protected] of 0.909 and 0.892, respectively, and figure extraction achieves a median IoU of 0.997. To support reproducibility, we additionally release the human-annotated ground-truth data, all trained models, and the full dataset generation pipeline.

Estimation eye gaze direction is useful in various human-computer interaction tasks. Knowledge of gaze direction can give valuable information regarding users point of attention. Certain patterns of eye movements known as eye accessing cues are reported to be related to the cognitive processes in the human brain. We propose a real-time framework for the classification of eye gaze direction and estimation of eye accessing cues. In the first stage, the algorithm detects faces using a modified version of the Viola-Jones algorithm. A rough eye region is obtained using geometric relations and facial landmarks. The eye region obtained is used in the subsequent stage to classify the eye gaze direction. A convolutional neural network is employed in this work for the classification of eye gaze direction. The proposed algorithm was tested on Eye Chimera database and found to outperform state of the art methods. The computational complexity of the algorithm is very less in the testing phase. The algorithm achieved an average frame rate of 24 fps in the desktop environment.

Diabetic retinopathy (DR) is a prevalent complication of diabetes associated with a significant risk of vision loss. Timely identification is critical to curb vision impairment. Algorithms for DR staging from digital fundus images (DFIs) have been recently proposed. However, models often fail to generalize due to distribution shifts between the source domain on which the model was trained and the target domain where it is deployed. A common and particularly challenging shift is often encountered when the source- and target-domain supports do not fully overlap. In this research, we introduce DRStageNet, a deep learning model designed to mitigate this challenge. We used seven publicly available datasets, comprising a total of 93,534 DFIs that cover a variety of patient demographics, ethnicities, geographic origins and comorbidities. We fine-tune DINOv2, a pretrained model of self-supervised vision transformer, and implement a multi-source domain fine-tuning strategy to enhance generalization performance. We benchmark and demonstrate the superiority of our method to two state-of-the-art benchmarks, including a recently published foundation model. We adapted the grad-rollout method to our regression task in order to provide high-resolution explainability heatmaps. The error analysis showed that 59\% of the main errors had incorrect reference labels. DRStageNet is accessible at URL [upon acceptance of the manuscript].

The caliber and configuration of retinal blood vessels serve as important biomarkers for various diseases and medical conditions. A thorough analysis of the retinal vasculature requires the segmentation of the blood vessels and their classification into arteries and veins, typically performed on color fundus images obtained by retinography. However, manually performing these tasks is labor-intensive and prone to human error. While several automated methods have been proposed to address this task, the current state of art faces challenges due to manifest classification errors affecting the topological consistency of segmentation maps. In this work, we introduce RRWNet, a novel end-to-end deep learning framework that addresses this limitation. The framework consists of a fully convolutional neural network that recursively refines semantic segmentation maps, correcting manifest classification errors and thus improving topological consistency. In particular, RRWNet is composed of two specialized subnetworks: a Base subnetwork that generates base segmentation maps from the input images, and a Recursive Refinement subnetwork that iteratively and recursively improves these maps. Evaluation on three different public datasets demonstrates the state-of-the-art performance of the proposed method, yielding more topologically consistent segmentation maps with fewer manifest classification errors than existing approaches. In addition, the Recursive Refinement module within RRWNet proves effective in post-processing segmentation maps from other methods, further demonstrating its potential. The model code, weights, and predictions will be publicly available at https://github.com/j-morano/rrwnet.

Camera pose matters. The position and orientation of each viewpoint define a shared spatial coordinate frame that relates observations across video frames. Yet this signal is largely absent from multimodal LLMs (MLLMs) for video understanding, which process frames as isolated 2D snapshots, instead of the persistent scene humans perceive. We revisit pose as a lightweight supervisory signal and introduce Cambrian-P, a video MLLM augmented with per-frame learnable camera tokens and a pose regression head. With a carefully designed sampling scheme, the model achieves substantial gains of 4.5-6.5% on spatial reasoning benchmarks such as VSI-Bench, generalizes across eight additional spatial and general video QA benchmarks, and, as a byproduct, achieves state of the art streaming pose estimation on ScanNet. Surprisingly, training on pseudo-annotated poses from in-the-wild video further improves general video QA benchmarks, showing pose helps beyond spatial reasoning. Together, these results position camera pose as a fundamental signal for video models that reason about the physical world.

Cats and humans differ in ocular anatomy. Most notably, Felis Catus (domestic cats) have vertically elongated pupils linked to ambush predation; yet, how such specializations manifest in downstream visual representations remains incompletely understood. We present a unified, frozen-encoder benchmark that quantifies feline-human cross-species representational alignment in the wild, across convolutional networks, supervised Vision Transformers, windowed transformers, and self-supervised ViTs (DINO), using layer-wise Centered Kernel Alignment (linear and RBF) and Representational Similarity Analysis, with additional distributional and stability tests reported in the paper. Across models, DINO ViT-B/16 attains the most substantial alignment (mean CKA-RBF approx0.814, mean CKA-linear approx0.745, mean RSA approx0.698), peaking at early blocks, indicating that token-level self-supervision induces early-stage features that bridge species-specific statistics. Supervised ViTs are competitive on CKA yet show weaker geometric correspondence than DINO (e.g., ViT-B/16 RSA approx0.53 at block8; ViT-L/16 approx0.47 at block14), revealing depth-dependent divergences between similarity and representational geometry. CNNs remain strong baselines but below plain ViTs on alignment, and windowed transformers underperform plain ViTs, implicating architectural inductive biases in cross-species alignment. Results indicate that self-supervision coupled with ViT inductive biases yields representational geometries that more closely align feline and human visual systems than widely used CNNs and windowed Transformers, providing testable neuroscientific hypotheses about where and how cross-species visual computations converge. We release our code and dataset for reference and reproducibility.

Perspective taking is a fundamental component of spatial intelligence, requiring models interpret spatial relations from a specified viewpoint, such as that of another entity or an imagined observer. Despite the increasing spatial reasoning capabilities of Vision-Language Models (VLMs), they still struggle with perspective taking, often defaulting to the camera viewpoint when a query requires reasoning from a different perspective. We introduce Learning Reference Coordinate Frames for Perspective Taking (LeRF), a framework that trains VLMs to construct and use explicit reference frames for viewpoint-dependent reasoning. Given an image and a query, LeRF decides whether a coordinate frame is necessary. If so, it grounds the reference entity and predicts the frame's origin and entity-centered reference frame. A lightweight renderer overlays the frame onto the image, enabling subsequent reasoning over these visual cues without external perception models or explicit 3D reconstruction. To learn this process, we first perform supervised fine-tuning to teach selective tool invocation and reference coordinate frame prediction, followed by reinforcement learning on spatial VQA pairs to improve frame-guided reasoning. Across diverse perspective-taking benchmarks, LeRF consistently improves over its backbone and achieves strong performance against existing open-source methods. Further evaluations also show improved reference-frame grounding and orientation estimation, supporting the effectiveness of learned reference frames for viewpoint-dependent reasoning.

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.

Optical coherence tomography (OCT) is a non-invasive imaging modality which is widely used in clinical ophthalmology. OCT images are capable of visualizing deep retinal layers which is crucial for early diagnosis of retinal diseases. In this paper, we describe a comprehensive open-access database containing more than 500 highresolution images categorized into different pathological conditions. The image classes include Normal (NO), Macular Hole (MH), Age-related Macular Degeneration (AMD), Central Serous Retinopathy (CSR), and Diabetic Retinopathy (DR). The images were obtained from a raster scan protocol with a 2mm scan length and 512x1024 pixel resolution. We have also included 25 normal OCT images with their corresponding ground truth delineations which can be used for an accurate evaluation of OCT image segmentation. In addition, we have provided a user-friendly GUI which can be used by clinicians for manual (and semi-automated) segmentation.

Scarcity of large publicly available retinal fundus image datasets for automated glaucoma detection has been the bottleneck for successful application of artificial intelligence towards practical Computer-Aided Diagnosis (CAD). A few small datasets that are available for research community usually suffer from impractical image capturing conditions and stringent inclusion criteria. These shortcomings in already limited choice of existing datasets make it challenging to mature a CAD system so that it can perform in real-world environment. In this paper we present a large publicly available retinal fundus image dataset for glaucoma classification called G1020. The dataset is curated by conforming to standard practices in routine ophthalmology and it is expected to serve as standard benchmark dataset for glaucoma detection. This database consists of 1020 high resolution colour fundus images and provides ground truth annotations for glaucoma diagnosis, optic disc and optic cup segmentation, vertical cup-to-disc ratio, size of neuroretinal rim in inferior, superior, nasal and temporal quadrants, and bounding box location for optic disc. We also report baseline results by conducting extensive experiments for automated glaucoma diagnosis and segmentation of optic disc and optic cup.

Human visual search is serial: the fovea must land on a candidate to confirm it, and those landings form a scanpath. Whether multimodal large language models (MLLMs), given the same foveated input, search as humans do bears on their use as models of human vision and on attention-alignment scores. We compare three general-purpose MLLMs with human eye-movement scanpaths on goal-directed search (COCO-Search18), driving each model fixation by fixation through an identical, human-matched foveated view and assessing it along three axes: the decision of target presence, the efficiency of reaching the target, and the gaze process itself. The axes dissociate. On the decision and on target acquisition the models match or exceed humans, detecting present targets near ceiling and reaching them on the first saccade more often than people do. The gaze process is not human. Under the human-matched condition, all three share one signature: low-entropy, large-amplitude, self-consistent scanpaths that agree with themselves far more closely than two humans agree with each other. That is consistent with a single-pass, non-serial architecture rather than a limit of acuity. Matched retinal input reproduces where humans look but not how the looking unfolds in time, and no degradation regime recovers human-like search at human-like success. The gap sits on a process axis that answer-alignment and saliency metrics do not measure. Because they miss it, such metrics cannot certify human-like vision, and zero-shot models suit outcome and spatial questions but not temporal, process-level ones.

Eye-tracking analysis plays a vital role in medical imaging, providing key insights into how radiologists visually interpret and diagnose clinical cases. In this work, we first analyze radiologists' attention and agreement by measuring the distribution of various eye-movement patterns, including saccades direction, amplitude, and their joint distribution. These metrics help uncover patterns in attention allocation and diagnostic strategies. Furthermore, we investigate whether and how doctors' gaze behavior shifts when viewing authentic (Real) versus deep-learning-generated (Fake) images. To achieve this, we examine fixation bias maps, focusing on first, last, short, and longest fixations independently, along with detailed saccades patterns, to quantify differences in gaze distribution and visual saliency between authentic and synthetic images.

Structural changes in retinal blood vessels are critical biomarkers for the onset and progression of glaucoma and other ocular diseases. However, current vessel segmentation approaches largely rely on supervised learning and extensive manual annotations, which are costly, error-prone, and difficult to obtain in optical coherence tomography angiography. Here we present BioVessel-Net, an unsupervised generative framework that integrates vessel biostatistics with adversarial refinement and a radius-guided segmentation strategy. Unlike pixel-based methods, BioVessel-Net directly models vascular structures with biostatistical coherence, achieving accurate and explainable vessel extraction without labeled data or high-performance computing. To support training and evaluation, we introduce RetinaMix, a new benchmark dataset of 2D and 3D OCTA images with high-resolution vessel details from diverse populations. Experimental results demonstrate that BioVessel-Net achieves near-perfect segmentation accuracy across RetinaMix and existing datasets, substantially outperforming state-of-the-art supervised and semi-supervised methods. Together, BioVessel-Net and RetinaMix provide a label-free, computationally efficient, and clinically interpretable solution for retinal vessel analysis, with broad potential for glaucoma monitoring, blood flow modeling, and progression prediction. Code and dataset are available: https://github.com/VikiXie/SatMar8.

Glaucoma is one of the leading causes of irreversible but preventable blindness in working age populations. Color fundus photography (CFP) is the most cost-effective imaging modality to screen for retinal disorders. However, its application to glaucoma has been limited to the computation of a few related biomarkers such as the vertical cup-to-disc ratio. Deep learning approaches, although widely applied for medical image analysis, have not been extensively used for glaucoma assessment due to the limited size of the available data sets. Furthermore, the lack of a standardize benchmark strategy makes difficult to compare existing methods in a uniform way. In order to overcome these issues we set up the Retinal Fundus Glaucoma Challenge, REFUGE (https://refuge.grand-challenge.org), held in conjunction with MICCAI 2018. The challenge consisted of two primary tasks, namely optic disc/cup segmentation and glaucoma classification. As part of REFUGE, we have publicly released a data set of 1200 fundus images with ground truth segmentations and clinical glaucoma labels, currently the largest existing one. We have also built an evaluation framework to ease and ensure fairness in the comparison of different models, encouraging the development of novel techniques in the field. 12 teams qualified and participated in the online challenge. This paper summarizes their methods and analyzes their corresponding results. In particular, we observed that two of the top-ranked teams outperformed two human experts in the glaucoma classification task. Furthermore, the segmentation results were in general consistent with the ground truth annotations, with complementary outcomes that can be further exploited by ensembling the results.

Our research is motivated by the urgent global issue of a large population affected by retinal diseases, which are evenly distributed but underserved by specialized medical expertise, particularly in non-urban areas. Our primary objective is to bridge this healthcare gap by developing a comprehensive diagnostic system capable of accurately predicting retinal diseases solely from fundus images. However, we faced significant challenges due to limited, diverse datasets and imbalanced class distributions. To overcome these issues, we have devised innovative strategies. Our research introduces novel approaches, utilizing hybrid models combining deeper Convolutional Neural Networks (CNNs), Transformer encoders, and ensemble architectures sequentially and in parallel to classify retinal fundus images into 20 disease labels. Our overarching goal is to assess these advanced models' potential in practical applications, with a strong focus on enhancing retinal disease diagnosis accuracy across a broader spectrum of conditions. Importantly, our efforts have surpassed baseline model results, with the C-Tran ensemble model emerging as the leader, achieving a remarkable model score of 0.9166, surpassing the baseline score of 0.9. Additionally, experiments with the IEViT model showcased equally promising outcomes with improved computational efficiency. We've also demonstrated the effectiveness of dynamic patch extraction and the integration of domain knowledge in computer vision tasks. In summary, our research strives to contribute significantly to retinal disease diagnosis, addressing the critical need for accessible healthcare solutions in underserved regions while aiming for comprehensive and accurate disease prediction.

Multimodal large language models (MLLMs) have recently demonstrated remarkable reasoning abilities with reinforcement learning paradigm. Although several multimodal reasoning models have been explored in the medical domain, most of them focus exclusively on basic reasoning, which refers to shallow inference based on visual feature matching. However, real-world clinical diagnosis extends beyond basic reasoning, demanding reasoning processes that integrate heterogeneous clinical information (such as chief complaints and medical history) with multimodal medical imaging data. To bridge this gap, we introduce MM-Retinal-Reason, the first ophthalmic multimodal dataset with the full spectrum of perception and reasoning. It encompasses both basic reasoning tasks and complex reasoning tasks, aiming to enhance visual-centric fundamental reasoning capabilities and emulate realistic clinical thinking patterns. Building upon MM-Retinal-Reason, we propose OphthaReason, the first ophthalmology-specific multimodal reasoning model with step-by-step reasoning traces. To enable flexible adaptation to both basic and complex reasoning tasks, we specifically design a novel method called Uncertainty-Aware Dynamic Thinking (UADT), which estimates sample-level uncertainty via entropy and dynamically modulates the model's exploration depth using a shaped advantage mechanism. Comprehensive experiments demonstrate that our model achieves state-of-the-art performance on both basic and complex reasoning tasks, outperforming general-purpose MLLMs, medical MLLMs, RL-based medical MLLMs, and ophthalmic MLLMs by at least 24.92\%, 15.00\%, 21.20\%, and 17.66\%. Project Page: https://github.com/lxirich/OphthaReason{link}.

Iris centre localization in low-resolution visible images is a challenging problem in computer vision community due to noise, shadows, occlusions, pose variations, eye blinks, etc. This paper proposes an efficient method for determining iris centre in low-resolution images in the visible spectrum. Even low-cost consumer-grade webcams can be used for gaze tracking without any additional hardware. A two-stage algorithm is proposed for iris centre localization. The proposed method uses geometrical characteristics of the eye. In the first stage, a fast convolution based approach is used for obtaining the coarse location of iris centre (IC). The IC location is further refined in the second stage using boundary tracing and ellipse fitting. The algorithm has been evaluated in public databases like BioID, Gi4E and is found to outperform the state of the art methods.

Positional embeddings (PE) play a crucial role in Vision Transformers (ViTs) by providing spatial information otherwise lost due to the permutation invariant nature of self attention. While absolute positional embeddings (APE) have shown theoretical advantages over relative positional embeddings (RPE), particularly due to the ability of sinusoidal functions to preserve spatial inductive biases like monotonicity and shift invariance, a fundamental challenge arises when mapping a 2D grid to a 1D sequence. Existing methods have mostly overlooked or never explored the impact of patch ordering in positional embeddings. To address this, we propose LOOPE, a learnable patch-ordering method that optimizes spatial representation for a given set of frequencies, providing a principled approach to patch order optimization. Empirical results show that our PE significantly improves classification accuracy across various ViT architectures. To rigorously evaluate the effectiveness of positional embeddings, we introduce the "Three Cell Experiment", a novel benchmarking framework that assesses the ability of PEs to retain relative and absolute positional information across different ViT architectures. Unlike standard evaluations, which typically report a performance gap of 4 to 6% between models with and without PE, our method reveals a striking 30 to 35% difference, offering a more sensitive diagnostic tool to measure the efficacy of PEs. Our experimental analysis confirms that the proposed LOOPE demonstrates enhanced effectiveness in retaining both relative and absolute positional information.

Humans do not passively observe the visual world -- we actively look in order to act. Motivated by this principle, we introduce EyeRobot, a robotic system with gaze behavior that emerges from the need to complete real-world tasks. We develop a mechanical eyeball that can freely rotate to observe its surroundings and train a gaze policy to control it using reinforcement learning. We accomplish this by first collecting teleoperated demonstrations paired with a 360 camera. This data is imported into a simulation environment that supports rendering arbitrary eyeball viewpoints, allowing episode rollouts of eye gaze on top of robot demonstrations. We then introduce a BC-RL loop to train the hand and eye jointly: the hand (BC) agent is trained from rendered eye observations, and the eye (RL) agent is rewarded when the hand produces correct action predictions. In this way, hand-eye coordination emerges as the eye looks towards regions which allow the hand to complete the task. EyeRobot implements a foveal-inspired policy architecture allowing high resolution with a small compute budget, which we find also leads to the emergence of more stable fixation as well as improved ability to track objects and ignore distractors. We evaluate EyeRobot on five panoramic workspace manipulation tasks requiring manipulation in an arc surrounding the robot arm. Our experiments suggest EyeRobot exhibits hand-eye coordination behaviors which effectively facilitate manipulation over large workspaces with a single camera. See project site for videos: https://www.eyerobot.net/

People with diabetes are at risk of developing an eye disease called diabetic retinopathy (DR). This disease occurs when high blood glucose levels cause damage to blood vessels in the retina. Computer-aided DR diagnosis is a promising tool for early detection of DR and severity grading, due to the great success of deep learning. However, most current DR diagnosis systems do not achieve satisfactory performance or interpretability for ophthalmologists, due to the lack of training data with consistent and fine-grained annotations. To address this problem, we construct a large fine-grained annotated DR dataset containing 2,842 images (FGADR). This dataset has 1,842 images with pixel-level DR-related lesion annotations, and 1,000 images with image-level labels graded by six board-certified ophthalmologists with intra-rater consistency. The proposed dataset will enable extensive studies on DR diagnosis. We set up three benchmark tasks for evaluation: 1. DR lesion segmentation; 2. DR grading by joint classification and segmentation; 3. Transfer learning for ocular multi-disease identification. Moreover, a novel inductive transfer learning method is introduced for the third task. Extensive experiments using different state-of-the-art methods are conducted on our FGADR dataset, which can serve as baselines for future research.

Understanding human visual attention on a scene over time has applications in domains such as interface design and inferring cognitive states. Modeling visual scanpaths has historically relied on specialized architectures with hand-crafted priors. While these architectures can model fixation sequences, their rigid structural biases restrict easy extendability and flexible conditioning. For instance, integrating task-specific instructions or adapting to distinct viewer identities requires custom, disjoint architectural additions. We frame scanpath prediction purely as a discrete sequence modeling task. By mapping coordinates into a text vocabulary, we leverage the pretrained representations of Vision-Language Models. This framing absorbs diverse factors of variation: simple prompting allows for global conditioning, such as providing viewer identities to capture personalized biases, or task-specific objectives like visual search. The framework can also integrate per-fixation attributes, such as individual fixation durations, alongside spatial locations. The autoregressive alignment enables the scalable, exact computation of per-fixation log-likelihoods, directly equivalent to the commonly used Information Gain (IG) metric. Our model, DeepGaze3.5-VL, establishes a new state-of-the-art across multiple datasets, achieving 2.18 bits of IG on MIT1003, a 46% improvement over DeepGaze III. This advantage persists even when baselines use identical high-capacity vision encoders. Beyond predictive performance, our generative framework serves as a powerful computational tool for direct behavioral interventions, allowing for controlled in-silico simulations that would be experimentally difficult or impossible to conduct in vivo. We demonstrate this ability by performing controlled interventions on the durations of pre-saccadic fixations, recovering known oculomotor phenomena purely from data.

Automatic extraction of retinal vascular biomarkers from color fundus images (CFI) is crucial for large-scale studies of the retinal vasculature. We present VascX, an open-source Python toolbox that extracts biomarkers from CFI artery-vein segmentations. VascX starts from vessel segmentation masks, extracts their skeletons, builds undirected and directed vessel graphs, and resolves vessel segments into longer vessels. A comprehensive set of biomarkers is derived, including vascular density, central retinal equivalents (CREs), and tortuosity. Spatially localized biomarkers may be calculated over grids placed relative to the fovea and optic disc. VascX is released via GitHub and PyPI with comprehensive documentation and examples. Our test-retest reproducibility analysis on repeat imaging of the same eye by different devices shows that most VascX biomarkers have moderate to excellent agreement (ICC > 0.5), with important differences in the level of robustness of different biomarkers. Our analyses of biomarker sensitivity to image perturbations and heuristic parameter values support these differences and further characterize VascX biomarkers. Ultimately, VascX provides an explainable and easily modifiable feature-extraction toolbox that complements segmentation to produce reliable retinal vascular biomarkers. Our graph-based biomarker computation stages support reproducible, region-aware measurements suited for large-scale clinical and epidemiological research. By enabling easy extraction of existing biomarkers and rapid experimentation with new ones, VascX supports oculomics research. Its robustness and computational efficiency facilitate scalable deployment in large databases, while open-source distribution lowers barriers to adoption for ophthalmic researchers and clinicians.

Image compression, restoration, and generation all require a way to measure how different two images look to a person. Pixel error ignores how people see, while the most accurate perceptual distances are typically fitted to human judgments, tying them to a fixed data and resolution. For example, when image resolution is doubled, the correlation of DISTS with human scores on TID2013 drops from 0.815 to 0.717. We introduce the Jacobian Lens Distance (JLD), which derives its perceptual geometry from a frozen vision encoder rather than from human labels. JLD combines the locality of early patch features with the perceptual sensitivity captured by later encoder representations. Specifically, we use the encoder Jacobian to identify directions in the early feature space that most strongly affect the encoder output, producing a fixed metric tensor, E[J^top J], which we call the Jacobian lens. The lens is fitted only once from 100 unlabeled images, taking about 35 seconds. Locally, this construction defines a pullback metric in pixel space, giving JLD a clear geometric interpretation that can be directly analyzed on real images. Across four standard perceptual databases, JLD achieves state-of-the-art performance and consistently outperforms LPIPS, DISTS, PieAPP, and DreamSim. JLD is also robust to changes in image resolution, on TID2013, its lens-term correlation remains nearly unchanged when the resolution is doubled, decreasing only from 0.850 to 0.845. We further introduce JLD-fast, which is 4times faster than LPIPS-VGG while achieving a mean correlation of 0.911. Finally, JLD naturally extends to video, reaching a correlation of 0.786 on Waterloo IVC 4K compared with 0.611 for VMAF.

Spatial instruction following has become a crucial requirement for text-to-image (T2I) generation. A common challenge arises when directional expressions are interpreted under different frames of reference. For example, ``the left of'' may refer to the viewer's image coordinates or to the intrinsic orientation of an object, leading to different expected layouts. Existing T2I benchmarks reveal important layout failures, yet they rarely isolate whether models can follow a specified frame of reference when it differs from camera view. To mitigate this gap, we introduce FoR-T2I, a benchmark for evaluating this distinction with 1,200 prompt pairs built from controlled spatial layouts. In each pair, the camera-view (Cam) prompt states the target relation in camera view, while the frame-of-reference (FoR) prompt describes the same target placement through an oriented anchor object. Across 22 closed-source and open-source T2I models, mean final accuracy is 41.8\% lower on FoR prompts than on matched Cam prompts; even the best-performing model achieves only 44.3\% FoR accuracy. This suggests that current models struggle more when the same layout is described through an object's orientation rather than directly in image coordinates. We further analyze this gap by relation type and camera view, compare several training-free prompting and feedback-based mitigation strategies, and propose a VLM-gated rewriting approach that selects rewritten prompts using visual feedback, improving average FoR accuracy from 25.0\% to 29.2\% under the same generation budget.

Reliable visual document understanding requires a model to attribute each answer to the evidence regions that support it. Recent benchmarks and systems express this step through a coordinate interface: the model outputs the coordinates of bounding boxes that mark the evidence regions in the document. Under this interface, vision-language models often fail to identify the right regions even when the answer is correct, a failure known as Attribution Hallucination. We present a study that investigates whether this failure is partially limited by what the model can express through coordinates. On a verified bilingual CiteVQA subset, we compare the coordinate interface with a language interface in which the model outputs only text, quoting its evidence verbatim, and a multimodal retriever returns the location of each quote as a page region proposed by a layout parser (tables and figures are quoted through their captions or notes); the comparison is repeated over six open vision-language models. Compared with the coordinate interface, evidence recall rises from at most 8 points to between 26 and 47 and the hallucination rate roughly halves, with little change in answer quality. Building on this comparison, we use the same quote-and-retrieve pipeline as a training scaffold: because region-level evidence labels are expensive to collect for long documents, we introduce a GRPO recipe whose reward is a judge's reading of the gold answer and crops of the retrieved regions, training the model to quote better evidence without any region labels and raising an 8B backbone's strict attributed accuracy from 22.4 to 33.8. These findings indicate a practical path to improve attribution"without a coordinate interface and without costly region-level supervision.

Recent graphical user interface (GUI) grounders have significantly advanced single-shot accuracy on standard benchmarks, yet their performance degrades sharply on small targets, densely packed controls and out-of-distribution interfaces. We attribute this gap to a paradigmatic limitation shared by existing approaches: none of them treats a produced coordinate as a hypothesis to be reflected upon and revised under new visual evidence. This manifests as three coupled issues: 1) Lack of post-hoc reflection. The prediction is frozen at the moment of emission, leaving no internal mechanism to challenge or refine it. 2) Visual evidence decoupled from the prediction. The auxiliary visual evidence is gathered to support the upcoming coordinate rather than to scrutinise the one already committed to. 3) Refinement over views, not over predictions. The iterative zoom-in refines the inspected region instead of inheriting a previous coordinate as a spatial prior to be corrected. In this paper, we propose LookAgain, a closed-loop GUI grounder driven by post-prediction visual reflection. LookAgain reformulates grounding as a multi-turn predict-look-again-refine process with two primitives: "locate" posts a coordinate hypothesis, renders a marker on the image and appends a local patch of the predicted region. It anchors the next reasoning step to the previous prediction as a spatial prior; "confirm" accepts or reject the hypothesis and terminates the procedure. We train the LookAgain grounder with SFT on constructed reflective trajectories as a cold start, followed by GRPO with terminal grounding correctness as the sole reward. Extensive experiments show that LookAgain consistently improves performance on both refusal-aware and general GUI grounding benchmarks, achieving state-of-the-art results. Comprehensive ablations further verify the effectiveness of the proposed framework.

We study positional encodings for multi-view transformers that process tokens from a set of posed input images, and seek a mechanism that encodes patches uniquely, allows SE(3)-invariant attention with multi-frequency similarity, and can be adaptive to the geometry of the underlying scene. We find that prior (absolute or relative) encoding schemes for multi-view attention do not meet the above desiderata, and present RayRoPE to address this gap. RayRoPE represents patch positions based on associated rays but leverages a predicted point along the ray instead of the direction for a geometry-aware encoding. To achieve SE(3) invariance, RayRoPE computes query-frame projective coordinates for computing multi-frequency similarity. Lastly, as the 'predicted' 3D point along a ray may not be precise, RayRoPE presents a mechanism to analytically compute the expected position encoding under uncertainty. We validate RayRoPE on the tasks of novel-view synthesis and stereo depth estimation and show that it consistently improves over alternate position encoding schemes (e.g. 15% relative improvement on LPIPS in CO3D). We also show that RayRoPE can seamlessly incorporate RGB-D input, resulting in even larger gains over alternatives that cannot positionally encode this information.

Although the preservation of shape continuity and physiological anatomy is a natural assumption in the segmentation of medical images, it is often neglected by deep learning methods that mostly aim for the statistical modeling of input data as pixels rather than interconnected structures. In biological structures, however, organs are not separate entities; for example, in reality, a severed vessel is an indication of an underlying problem, but traditional segmentation models are not designed to strictly enforce the continuity of anatomy, potentially leading to inaccurate medical diagnoses. To address this issue, we propose a graph-based approach that enforces the continuity and connectivity of anatomical topology in medical images. Our method encodes the continuity of shapes as a graph constraint, ensuring that the network's predictions maintain this continuity. We evaluate our method on two public benchmarks on retinal vessel segmentation, showing significant improvements in connectivity metrics compared to traditional methods while getting better or on-par performance on segmentation metrics.

The goal of this work is to characterize the representational impact that foveation operations have for machine vision systems, inspired by the foveated human visual system, which has higher acuity at the center of gaze and texture-like encoding in the periphery. To do so, we introduce models consisting of a first-stage fixed image transform followed by a second-stage learnable convolutional neural network, and we varied the first stage component. The primary model has a foveated-textural input stage, which we compare to a model with foveated-blurred input and a model with spatially-uniform blurred input (both matched for perceptual compression), and a final reference model with minimal input-based compression. We find that: 1) the foveated-texture model shows similar scene classification accuracy as the reference model despite its compressed input, with greater i.i.d. generalization than the other models; 2) the foveated-texture model has greater sensitivity to high-spatial frequency information and greater robustness to occlusion, w.r.t the comparison models; 3) both the foveated systems, show a stronger center image-bias relative to the spatially-uniform systems even with a weight sharing constraint. Critically, these results are preserved over different classical CNN architectures throughout their learning dynamics. Altogether, this suggests that foveation with peripheral texture-based computations yields an efficient, distinct, and robust representational format of scene information, and provides symbiotic computational insight into the representational consequences that texture-based peripheral encoding may have for processing in the human visual system, while also potentially inspiring the next generation of computer vision models via spatially-adaptive computation. Code + Data available here: https://github.com/ArturoDeza/EmergentProperties

Visual navigation ability is strongly tied to its underlying representation of the world. Unlike classical 3D maps that require globally-consistent geometry, image- or object-relative topological graphs almost entirely do away with geometric understanding. But, this comes at the cost of navigation capability, often limiting it to merely teach-and-repeat. In this work, we propose a novel map representation in the form of pixel-relative connectivity, which is geometrically accurate but does not require global geometric consistency. Inspired by recent progress in 3D grounded image matching, we construct a map from an image sequence through inter-image connectivity based on pixel correspondences in the relative 3D coordinate systems of individual image pairs. We then use this pixel-level graph to perform global path planning by approximating and sparsifying intra-image pixel connectivity. Through this, we derive a ''WayPixel Costmap'' representation and train a controller conditioned on it to predict a trajectory rollout. We show that this dense pixel-level costmap based on relative geometry is a more accurate conditioning variable for control prediction than its image- and object-level counterparts. This enables a highly capable navigation system, as validated on four types of navigation tasks in the simulator and through real world demonstrations.

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.

Medical eye-tracking data is an important information source for understanding how radiologists visually interpret medical images. This information not only improves the accuracy of deep learning models for X-ray analysis but also their interpretability, enhancing transparency in decision-making. However, the current eye-tracking data is dispersed, unprocessed, and ambiguous, making it difficult to derive meaningful insights. Therefore, there is a need to create a new dataset with more focus and purposeful eyetracking data, improving its utility for diagnostic applications. In this work, we propose a refinement method inspired by the target-present visual search challenge: there is a specific finding and fixations are guided to locate it. After refining the existing eye-tracking datasets, we transform them into a curated visual search dataset, called GazeSearch, specifically for radiology findings, where each fixation sequence is purposefully aligned to the task of locating a particular finding. Subsequently, we introduce a scan path prediction baseline, called ChestSearch, specifically tailored to GazeSearch. Finally, we employ the newly introduced GazeSearch as a benchmark to evaluate the performance of current state-of-the-art methods, offering a comprehensive assessment for visual search in the medical imaging domain. Code is available at https://github.com/UARK-AICV/GazeSearch.

Current fundus image analysis models are predominantly built for specific tasks relying on individual datasets. The learning process is usually based on data-driven paradigm without prior knowledge, resulting in poor transferability and generalizability. To address this issue, we propose MM-Retinal, a multi-modal dataset that encompasses high-quality image-text pairs collected from professional fundus diagram books. Moreover, enabled by MM-Retinal, we present a novel Knowledge-enhanced foundational pretraining model which incorporates Fundus Image-Text expertise, called KeepFIT. It is designed with image similarity-guided text revision and mixed training strategy to infuse expert knowledge. Our proposed fundus foundation model achieves state-of-the-art performance across six unseen downstream tasks and holds excellent generalization ability in zero-shot and few-shot scenarios. MM-Retinal and KeepFIT are available at https://github.com/lxirich/MM-Retinal.

GUI grounding, the task of mapping natural-language instructions to pixel coordinates, is crucial for autonomous agents, yet remains difficult for current VLMs. The core bottleneck is reliable patch-to-pixel mapping, which breaks when extrapolating to high-resolution displays unseen during training. Current approaches generate coordinates as text tokens directly from visual features, forcing the model to infer complex position-to-pixel mappings implicitly; as a result, accuracy degrades and failures proliferate on new resolutions. We address this with two complementary innovations. First, RULER tokens serve as explicit coordinate markers, letting the model reference positions similar to gridlines on a map and adjust rather than generate coordinates from scratch. Second, Interleaved MRoPE (I-MRoPE) improves spatial encoding by ensuring that width and height dimensions are represented equally, addressing the asymmetry of standard positional schemes. Experiments on ScreenSpot, ScreenSpot-V2, and ScreenSpot-Pro show consistent gains in grounding accuracy, with the largest improvements on high-resolution interfaces. By providing explicit spatial guidance rather than relying on implicit learning, our approach enables more reliable GUI automation across diverse resolutions and platforms.

MLLM-based GUI grounding methods commonly formulate target localization as autoregressive coordinate generation, enabling models to leverage the strong instruction-following and semantic understanding capabilities of MLLMs. However, this formulation requires the model to retain region-level target evidence while decoding coordinate tokens with the spatial precision demanded by GUI clicking. Our diagnostic analysis reveals that target-region awareness emerges in intermediate decoder layers but is neither retained nor translated into the final coordinate prediction. Existing ZoomIn-style methods address this issue through an external crop-and-rerun pass, which improves localization but increases end-to-end latency and computational cost. To retain the accuracy benefits of two-pass zooming without this extra cost, we propose InnerZoom, a single-forward framework for cross-layer evidence bridging. InnerZoom transforms target-related cues from the original forward pass into a compact cross-layer evidence state, then preserves, refines, and reinjects this state throughout later decoding layers to guide coordinate prediction. Extensive experimental results suggest that InnerZoom-4B achieves state-of-the-art performance on all six GUI grounding benchmarks, obtaining 64.7 on OSWorld-G, 40.2 on UI-Vision, 73.1 on OSWorld-GR, and 87.6 on MMBench-GUI, surpassing the previous best results by 4.1, 3.2, 2.9, and 2.3 points, respectively. Under a controlled 4B setting, InnerZoom improves the same SFT+RL baseline by 5.3 points on average and outperforms two-pass ZoomIn by 1.3 points on average, while reducing end-to-end latency by up to 31.8% and TFLOPs by about 29%. Code and models will be publicly available.

Coordinate networks are widely used in computer vision due to their ability to represent signals as compressed, continuous entities. However, training these networks with first-order optimizers can be slow, hindering their use in real-time applications. Recent works have opted for shallow voxel-based representations to achieve faster training, but this sacrifices memory efficiency. This work proposes a solution that leverages second-order optimization methods to significantly reduce training times for coordinate networks while maintaining their compressibility. Experiments demonstrate the effectiveness of this approach on various signal modalities, such as audio, images, videos, shape reconstruction, and neural radiance fields.

Vision disorders significantly impact millions of lives, altering how visual information is processed and perceived. In this work, a computational framework was developed using the BrokenEyes system to simulate five common eye disorders: Age-related macular degeneration, cataract, glaucoma, refractive errors, and diabetic retinopathy and analyze their effects on neural-like feature representations in deep learning models. Leveraging a combination of human and non-human datasets, models trained under normal and disorder-specific conditions revealed critical disruptions in feature maps, particularly for cataract and glaucoma, which align with known neural processing challenges in these conditions. Evaluation metrics such as activation energy and cosine similarity quantified the severity of these distortions, providing insights into the interplay between degraded visual inputs and learned representations.

The prevalence of vision-threatening eye diseases is a significant global burden, with many cases remaining undiagnosed or diagnosed too late for effective treatment. Large vision-language models (LVLMs) have the potential to assist in understanding anatomical information, diagnosing eye diseases, and drafting interpretations and follow-up plans, thereby reducing the burden on clinicians and improving access to eye care. However, limited benchmarks are available to assess LVLMs' performance in ophthalmology-specific applications. In this study, we introduce LMOD, a large-scale multimodal ophthalmology benchmark consisting of 21,993 instances across (1) five ophthalmic imaging modalities: optical coherence tomography, color fundus photographs, scanning laser ophthalmoscopy, lens photographs, and surgical scenes; (2) free-text, demographic, and disease biomarker information; and (3) primary ophthalmology-specific applications such as anatomical information understanding, disease diagnosis, and subgroup analysis. In addition, we benchmarked 13 state-of-the-art LVLM representatives from closed-source, open-source, and medical domains. The results demonstrate a significant performance drop for LVLMs in ophthalmology compared to other domains. Systematic error analysis further identified six major failure modes: misclassification, failure to abstain, inconsistent reasoning, hallucination, assertions without justification, and lack of domain-specific knowledge. In contrast, supervised neural networks specifically trained on these tasks as baselines demonstrated high accuracy. These findings underscore the pressing need for benchmarks in the development and validation of ophthalmology-specific LVLMs.

Several ongoing international efforts are developing methods of localizing single cells within organs or mapping the entire human body at the single cell level, including the Chan Zuckerberg Initiative's Human Cell Atlas (HCA), and the Knut and Allice Wallenberg Foundation's Human Protein Atlas (HPA), and the National Institutes of Health's Human BioMolecular Atlas Program (HuBMAP). Their goals are to understand cell specialization, interactions, spatial organization in their natural context, and ultimately the function of every cell within the body. In the same way that the Human Genome Project had to assemble sequence data from different people to construct a complete sequence, multiple centers around the world are collecting tissue specimens from a diverse population that varies in age, race, sex, and body size. A challenge will be combining these heterogeneous tissue samples into a 3D reference map that will enable multiscale, multidimensional Google Maps-like exploration of the human body. Key to making alignment of tissue samples work is identifying and using a coordinate system called a Common Coordinate Framework (CCF), which defines the positions, or "addresses", in a reference body, from whole organs down to functional tissue units and individual cells. In this perspective, we examine the concept of a CCF based on the vasculature and describe why it would be an attractive choice for mapping the human body.

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.

How different populations visually explore artworks bears on cognitive science and on accessibility design, yet most eye-tracking work in autism has used social scenes rather than art, and has analysed where the eyes land while ignoring when and in what order. We present a comparative free-viewing study across three groups, autistic adults (ASD), trained artists, and neurotypical observers, who each viewed 30 paintings for 15s. We introduce a directed, metric-grounded framework that compares groups along two complementary axes: a spatial axis, in which one group's fixation-density map predicts another's fixations under six saliency metrics (AUC-Judd, NSS, CC, SIM, KL, Information Gain); and a temporal axis, in which individual scanpaths are compared with MultiMatch, ScanMatch, a foveal-disc IoU score (FDISS), and dynamic time warping (DTW). Fixations are extracted uniformly for all groups with a dispersion-threshold algorithm. Three results converge. (i)Artists and neurotypicals are almost indistinguishable in both space (density-map correlation CC=0.96) and time (they form the most alignable scanpath pair), whereas ASD gaze diverges from both. (ii)ASD attention is dissociated: it matches artists' wide spatial exploration (dispersion, explored area) but carries a distinct temporal signature, shorter fixations, less dwell, and the most idiosyncratic (least self-consistent) scanpaths of any group. (iii)ASD gaze is not selectively artist-like on any metric; if anything it is marginally closer to neurotypical. Together these findings indicate that autistic viewing of art is a distinct, group-specific attentional profile in both space and time, and they motivate population-conditioned models of aesthetic attention. We release all analysis code and per-stimulus results.

Optical coherence tomography (OCT) imaging is essential for the diagnosis and treatment of retinal diseases. Although multimodal large language models (MLLMs) have demonstrated considerable potential in medical image analysis, existing benchmarks largely reduce OCT understanding to coarse-grained disease classification or isolated visual question answering, leaving the complete cognitive process from visual perception to clinical reasoning insufficiently evaluated. To address this limitation, we introduce OCT-Bench, a comprehensive benchmark dedicated to OCT image understanding. OCT-Bench comprises 10,076 high-quality multiple-choice questions constructed from 4,137 OCT images across seven public datasets. Following the real-world clinical interpretation workflow, we establish a hierarchical capability taxonomy consisting of 20 fine-grained tasks across three dimensions: Perception, Cognition, and Reasoning. These tasks cover a broad range of capabilities, including imaging attributes, retinal anatomy, lesion characteristics, spatial relationships, disease assessment, therapeutic decision-making, and prognostic management. We systematically evaluate 20 representative MLLMs, including proprietary models, open-source general-purpose models, and medical-domain models. Experimental results demonstrate that current models remain substantially short of reliable OCT understanding. Moreover, neither medical-domain adaptation nor increased model scale consistently improves performance across capability levels. OCT-Bench enables comprehensive and fine-grained evaluation of MLLMs, providing a foundation for identifying capability bottlenecks and advancing clinically grounded OCT understanding.

Anatomy-aware colonoscopic navigation requires localizing partial endoscopic observations on a stable 3D reference to support coverage assessment, revisited-region awareness, and CT-guided navigation. However, rigid point cloud registration in the colon differs fundamentally from standard benchmarks: surfaces are locally homogeneous, haustral folds are repetitive, views are highly partial, and reconstructed depth is noisy. We present C3VDReg, a dataset and benchmark derived from the Colonoscopy 3D Video Dataset (C3VD). For each frame, C3VDReg generates source point clouds via depth reprojection and target point clouds by raycasting CT meshes from matched camera poses. The benchmark comprises 10,015 viewpoint-matched partial-to-partial point cloud pairs (including 2,088 held-out test pairs) and evaluates baseline models under a standardized protocol: 8,192 points per cloud, source-only perturbations, fixed pose conventions, and unified metrics. Crucially, C3VDReg enables a systematic investigation of failure modes. We find that high geometric overlap alone is insufficient for reliable pose recovery: despite 74.3-93.1% ground-truth overlap, registration recall remains low across all evaluated methods. Through overlap, pose error, and translation decomposition analyses, we identify translation ambiguity along repetitive tubular anatomy as the primary bottleneck. This challenges the common assumption that increasing overlap or correspondence quality guarantees accurate registration, highlighting the need for stronger anatomical and contextual constraints. Code, model checkpoints, and data are available at https://github.com/linzhe001/C3VDReg .

We present SPAD, a novel approach for creating consistent multi-view images from text prompts or single images. To enable multi-view generation, we repurpose a pretrained 2D diffusion model by extending its self-attention layers with cross-view interactions, and fine-tune it on a high quality subset of Objaverse. We find that a naive extension of the self-attention proposed in prior work (e.g. MVDream) leads to content copying between views. Therefore, we explicitly constrain the cross-view attention based on epipolar geometry. To further enhance 3D consistency, we utilize Plucker coordinates derived from camera rays and inject them as positional encoding. This enables SPAD to reason over spatial proximity in 3D well. In contrast to recent works that can only generate views at fixed azimuth and elevation, SPAD offers full camera control and achieves state-of-the-art results in novel view synthesis on unseen objects from the Objaverse and Google Scanned Objects datasets. Finally, we demonstrate that text-to-3D generation using SPAD prevents the multi-face Janus issue. See more details at our webpage: https://yashkant.github.io/spad

We present a simple mathematical model for the mammalian low visual pathway, taking into account its key elements: retina, lateral geniculate nucleus (LGN), primary visual cortex (V1). The analogies between the cortical level of the visual system and the structure of popular CNNs, used in image classification tasks, suggests the introduction of an additional preliminary convolutional module inspired to precortical neuronal circuits to improve robustness with respect to global light intensity and contrast variations in the input images. We validate our hypothesis on the popular databases MNIST, FashionMNIST and SVHN, obtaining significantly more robust CNNs with respect to these variations, once such extra module is added.

The precise segmentation of retinal blood vessels is of great significance for early diagnosis of eye-related diseases such as diabetes and hypertension. In this work, we propose a lightweight network named Spatial Attention U-Net (SA-UNet) that does not require thousands of annotated training samples and can be utilized in a data augmentation manner to use the available annotated samples more efficiently. SA-UNet introduces a spatial attention module which infers the attention map along the spatial dimension, and multiplies the attention map by the input feature map for adaptive feature refinement. In addition, the proposed network employs structured dropout convolutional blocks instead of the original convolutional blocks of U-Net to prevent the network from overfitting. We evaluate SA-UNet based on two benchmark retinal datasets: the Vascular Extraction (DRIVE) dataset and the Child Heart and Health Study (CHASE_DB1) dataset. The results show that the proposed SA-UNet achieves state-of-the-art performance on both datasets.The implementation and the trained networks are available on Github1.

In this paper, we address the challenge of making ViT models more robust to unseen affine transformations. Such robustness becomes useful in various recognition tasks such as face recognition when image alignment failures occur. We propose a novel method called KP-RPE, which leverages key points (e.g.~facial landmarks) to make ViT more resilient to scale, translation, and pose variations. We begin with the observation that Relative Position Encoding (RPE) is a good way to bring affine transform generalization to ViTs. RPE, however, can only inject the model with prior knowledge that nearby pixels are more important than far pixels. Keypoint RPE (KP-RPE) is an extension of this principle, where the significance of pixels is not solely dictated by their proximity but also by their relative positions to specific keypoints within the image. By anchoring the significance of pixels around keypoints, the model can more effectively retain spatial relationships, even when those relationships are disrupted by affine transformations. We show the merit of KP-RPE in face and gait recognition. The experimental results demonstrate the effectiveness in improving face recognition performance from low-quality images, particularly where alignment is prone to failure. Code and pre-trained models are available.

Radiologists rely on eye movements to navigate and interpret medical images. A trained radiologist possesses knowledge about the potential diseases that may be present in the images and, when searching, follows a mental checklist to locate them using their gaze. This is a key observation, yet existing models fail to capture the underlying intent behind each fixation. In this paper, we introduce a deep learning-based approach, RadGazeIntent, designed to model this behavior: having an intention to find something and actively searching for it. Our transformer-based architecture processes both the temporal and spatial dimensions of gaze data, transforming fine-grained fixation features into coarse, meaningful representations of diagnostic intent to interpret radiologists' goals. To capture the nuances of radiologists' varied intention-driven behaviors, we process existing medical eye-tracking datasets to create three intention-labeled subsets: RadSeq (Systematic Sequential Search), RadExplore (Uncertainty-driven Exploration), and RadHybrid (Hybrid Pattern). Experimental results demonstrate RadGazeIntent's ability to predict which findings radiologists are examining at specific moments, outperforming baseline methods across all intention-labeled datasets.

Artificial intelligence (AI) is vital in ophthalmology, tackling tasks like diagnosis, classification, and visual question answering (VQA). However, existing AI models in this domain often require extensive annotation and are task-specific, limiting their clinical utility. While recent developments have brought about foundation models for ophthalmology, they are limited by the need to train separate weights for each imaging modality, preventing a comprehensive representation of multi-modal features. This highlights the need for versatile foundation models capable of handling various tasks and modalities in ophthalmology. To address this gap, we present EyeFound, a multimodal foundation model for ophthalmic images. Unlike existing models, EyeFound learns generalizable representations from unlabeled multimodal retinal images, enabling efficient model adaptation across multiple applications. Trained on 2.78 million images from 227 hospitals across 11 ophthalmic modalities, EyeFound facilitates generalist representations and diverse multimodal downstream tasks, even for detecting challenging rare diseases. It outperforms previous work RETFound in diagnosing eye diseases, predicting systemic disease incidents, and zero-shot multimodal VQA. EyeFound provides a generalizable solution to improve model performance and lessen the annotation burden on experts, facilitating widespread clinical AI applications for retinal imaging.

Despite recent advances in medical vision-language pretraining, existing models still struggle to capture the diagnostic workflow: radiographs are typically treated as context-agnostic images, while radiologists' gaze -- a crucial cue for visual reasoning -- remains largely underexplored by existing methods. These limitations hinder the modeling of disease-specific patterns and weaken cross-modal alignment. To bridge this gap, we introduce CoGaze, a Context- and Gaze-guided vision-language pretraining framework for chest X-rays. We first propose a context-infused vision encoder that models how radiologists integrate clinical context -- including patient history, symptoms, and diagnostic intent -- to guide diagnostic reasoning. We then present a multi-level supervision paradigm that (1) enforces intra- and inter-modal semantic alignment through hybrid-positive contrastive learning, (2) injects diagnostic priors via disease-aware cross-modal representation learning, and (3) leverages radiologists' gaze as probabilistic priors to guide attention toward diagnostically salient regions. Extensive experiments demonstrate that CoGaze consistently outperforms state-of-the-art methods across diverse tasks, achieving up to +2.0% CheXbertF1 and +1.2% BLEU2 for free-text and structured report generation, +23.2% AUROC for zero-shot classification, and +12.2% Precision@1 for image-text retrieval. Code is available at https://github.com/mk-runner/CoGaze.

High-frequency surgical maneuvers in ophthalmology necessitate high-fidelity temporal modeling, yet characterizing long-range procedural dependencies remains computationally prohibitive for attention-based architectures. Existing models often require aggressive temporal downsampling, which compromises the detection of fine-grained action boundaries and instrument-tissue interactions. To address these scalability constraints, we present OphBiWSSD, a framework that reformulates surgical temporal action localization leveraging Bidirectional State Space Duality. By employing a weight-tied selective scan mechanism that incorporates both preceding and succeeding surgical contexts, our approach facilitates the global synthesis of non-causal temporal cues with linear complexity. This streamlined architecture is well-suited to capture the bidirectional dependencies present in ophthalmic workflows, effectively bridging the gap between local boundary precision and long-range procedural context without incurring the quadratic memory overhead of traditional Transformers. Extensive experiments on the OphNet benchmark demonstrate that OphBiWSSD achieves state-of-the-art temporal localization performance, with mean Average Precisions of 44.42% on phases and 43.08% on operations, surpassing the baselines by 6.80% and 6.66%, respectively. Empirical validation indicates that our approach ensures precise temporal localization and offers a computationally viable pathway for deploying surgical intelligence systems in clinical environments. The code is publicly available at https://github.com/yo3nglau/OphBiWSSD.

Graphical User Interface (GUI) grounding is commonly framed as a coordinate prediction task -- given a natural language instruction, generate on-screen coordinates for actions such as clicks and keystrokes. However, recent Vision Language Models (VLMs) often fail to predict accurate numeric coordinates when processing high-resolution GUI images with complex layouts. To address this issue, we reframe GUI grounding as an interactive search task, where the VLM generates actions to move a cursor in the GUI to locate UI elements. At each step, the model determines the target object, evaluates the spatial relations between the cursor and the target, and moves the cursor closer to the target conditioned on the movement history. In this interactive process, the rendered cursor provides visual feedback to help the model align its predictions with the corresponding on-screen locations. We train our GUI grounding model, GUI-Cursor, using multi-step online reinforcement learning with a dense trajectory-based reward function. Our experimental results show that GUI-Cursor, based on Qwen2.5-VL-7B, improves the GUI grounding accuracy and achieves state-of-the-art results on ScreenSpot-v2 (88.8% rightarrow 93.9%) and ScreenSpot-Pro (26.8% rightarrow 56.5%). Moreover, we observe that GUI-Cursor learns to solve the problem within two steps for 95\% of instances and can adaptively conduct more steps on more difficult examples.

Single-image 3D object generation can now produce high-fidelity assets, yet accurately placing them into a coherent scene layout remains an open challenge. A central difficulty lies in how object layout is represented. Holistic methods absorb placement into a scene-level generation process, sacrificing object-level detail. Compositional methods preserve object fidelity by decoupling geometry from layout, but typically parameterize layout as sparse, unbounded pose variables that are difficult to learn and generalize poorly under scarce scene-level supervision.We present Mira-Scene, a compositional 3D scene reconstruction framework that replaces sparse pose regression with dense, bounded correspondence recovery. At its core is the Canonical Coordinate Map (CCM), a pixel-aligned field that maps each visible object pixel to a surface coordinate in the object's bounded canonical space. When paired with a scene-space Point Cloud Map (PCM) from monocular geometry estimation, CCM induces dense canonical-to-scene correspondences from which object transformations are recovered through robust geometric alignment. Because CCM operates in bounded canonical space, it provides a stable prediction target that can be trained from scalable object-level 3D data without requiring scene-level layout annotations. Mira-Scene further introduces a multimodal diffusion transformer that jointly generates object geometry and CCMs, using modality-specific expert streams with shared attention and positional encoding to promote geometry-layout consistency. Experiments on indoor, outdoor, synthetic, and in-the-wild scenes show that Mira-Scene substantially outperforms strong baselines in layout accuracy, achieving relative gains of 39.8% in 3D-IoU and 16.5% in 2D-IoU over SAM3D, using limited open-source training data.

While exploring visual scenes, humans' scanpaths are driven by their underlying attention processes. Understanding visual scanpaths is essential for various applications. Traditional scanpath models predict the where and when of gaze shifts without providing explanations, creating a gap in understanding the rationale behind fixations. To bridge this gap, we introduce GazeXplain, a novel study of visual scanpath prediction and explanation. This involves annotating natural-language explanations for fixations across eye-tracking datasets and proposing a general model with an attention-language decoder that jointly predicts scanpaths and generates explanations. It integrates a unique semantic alignment mechanism to enhance the consistency between fixations and explanations, alongside a cross-dataset co-training approach for generalization. These novelties present a comprehensive and adaptable solution for explainable human visual scanpath prediction. Extensive experiments on diverse eye-tracking datasets demonstrate the effectiveness of GazeXplain in both scanpath prediction and explanation, offering valuable insights into human visual attention and cognitive processes.

The oxygen saturation level in the blood (SaO2) is crucial for health, particularly in relation to sleep-related breathing disorders. However, continuous monitoring of SaO2 is time-consuming and highly variable depending on patients' conditions. Recently, optical coherence tomography angiography (OCTA) has shown promising development in rapidly and effectively screening eye-related lesions, offering the potential for diagnosing sleep-related disorders. To bridge this gap, our paper presents three key contributions. Firstly, we propose JointViT, a novel model based on the Vision Transformer architecture, incorporating a joint loss function for supervision. Secondly, we introduce a balancing augmentation technique during data preprocessing to improve the model's performance, particularly on the long-tail distribution within the OCTA dataset. Lastly, through comprehensive experiments on the OCTA dataset, our proposed method significantly outperforms other state-of-the-art methods, achieving improvements of up to 12.28% in overall accuracy. This advancement lays the groundwork for the future utilization of OCTA in diagnosing sleep-related disorders. See project website https://steve-zeyu-zhang.github.io/JointViT

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.

Vision-language models (VLMs) have shown increasing potential for medical image understanding, yet their capabilities in ophthalmic imaging remain insufficiently characterized. Existing ophthalmic datasets are typically designed for individual diseases or specialized tasks, making it difficult to systematically evaluate whether VLMs can move beyond disease recognition toward comparative reasoning and fine-grained spatial grounding. We introduce EyeVQA, a unified visual question answering benchmark for comprehensive evaluation of ophthalmic VLMs. EyeVQA is constructed from 21 available ophthalmic datasets and contains 20,000 question-answer pairs spanning six disease groups and seven question types: Single-Choice, Multi-Select, Variable-Select, True-False, Ranking, Point Location, and Bounding Box. Gold answers are deterministically derived from source-provided diagnoses, severity grades, clinical findings, segmentation masks, bounding boxes, and anatomical landmarks, enabling reproducible evaluation without relying on model-generated annotations. Notably, 44.5% of the questions require reasoning across multiple images, extending evaluation beyond conventional single-image medical VQA. We benchmark fourteen representative general-purpose, scientific, and medically specialized VLMs under a unified zero-shot protocol. The best-performing model only achieves an overall score of 62.8, while substantial gaps remain in spatial grounding and cross-task generalization. These results highlight the limitations of current VLMs in comprehensive ophthalmic visual understanding and establish EyeVQA as a diagnostic benchmark for developing more reliable and spatially grounded ophthalmic multimodal models. The project page is available at https://github.com/PKUTHM/EyeVQA.

In October 2007, a Research Proposal for the University of Sydney, Australia, the author suggested that biovie-physical phenomenon as `electrodynamic dependant biological vision', is governed by relativistic quantum laws and biovision. The phenomenon on the basis of `biovielectroluminescence', satisfies man/microbio/megabio/computer vision (MMMCV), as a robust candidate for physical and visual sciences. The general aim of this addendum is to present a refined text of Sections 1-3 of that proposal and highlighting the contents of its Appendix in form of a `Mechanisms' Section. We then briefly remind in an article aimed for December 2007, by appending two more equations into Section 3, a theoretical II-time scenario as a time model well-proposed for the phenomenon. The time model within the core of the proposal, plays a significant role in emphasizing the principle points on Objectives no. 1-8, Sub-hypothesis 3.1.2, mentioned in Article [arXiv:0710.0410]. It also expresses the time concept in terms of causing quantized energy f(|E|) of time |t|, emit in regard to shortening the probability of particle loci as predictable patterns of particle's un-occurred motion, a solution to Heisenberg's uncertainty principle (HUP) into a simplistic manner. We conclude that, practical frames via a time algorithm to this model, fixates such predictable patterns of motion of scenery bodies onto recordable observation points of a MMMCV system. It even suppresses/predicts superposition phenomena coming from a human subject and/or other bio-subjects for any decision making event, e.g., brainwave quantum patterns based on vision. Maintaining the existential probability of Riemann surfaces of II-time scenarios in the context of biovielectroluminescence, makes motion-prediction a possibility.

Fundus imaging such as CFP, OCT and UWF is crucial for the early detection of retinal anomalies and diseases. Fundus image understanding, due to its knowledge-intensive nature, poses a challenging vision-language task. An emerging approach to addressing the task is to post-train a generic multimodal large language model (MLLM), either by supervised finetuning (SFT) or by reinforcement learning with verifiable rewards (RLVR), on a considerable amount of in-house samples paired with high-quality clinical reports. However, these valuable samples are not publicly accessible, which not only hinders reproducibility but also practically limits research to few players. To overcome the barrier, we make a novel attempt to train a reasoning-enhanced fundus-reading MLLM, which we term Fundus-R1, using exclusively public datasets, wherein over 94\% of the data are annotated with only image-level labels. Our technical contributions are two-fold. First, we propose a RAG-based method for composing image-specific, knowledge-aware reasoning traces. Such auto-generated traces link visual findings identified by a generic MLLM to the image labels in terms of ophthalmic knowledge. Second, we enhance RLVR with a process reward that encourages self-consistency of the generated reasoning trace in each rollout. Extensive experiments on three fundus-reading benchmarks, i.e., FunBench, Omni-Fundus and GMAI-Fundus, show that Fundus-R1 clearly outperforms multiple baselines, including its generic counterpart (Qwen2.5-VL) and a stronger edition post-trained without using the generated traces. This work paves the way for training powerful fundus-reading MLLMs with publicly available data.

While existing large vision-language multimodal models focus on whole image understanding, there is a prominent gap in achieving region-specific comprehension. Current approaches that use textual coordinates or spatial encodings often fail to provide a user-friendly interface for visual prompting. To address this challenge, we introduce a novel multimodal model capable of decoding arbitrary visual prompts. This allows users to intuitively mark images and interact with the model using natural cues like a "red bounding box" or "pointed arrow". Our simple design directly overlays visual markers onto the RGB image, eliminating the need for complex region encodings, yet achieves state-of-the-art performance on region-understanding tasks like Visual7W, PointQA, and Visual Commonsense Reasoning benchmark. Furthermore, we present ViP-Bench, a comprehensive benchmark to assess the capability of models in understanding visual prompts across multiple dimensions, enabling future research in this domain. Code, data, and model are publicly available.

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.

Grounding has become a fundamental capability of vision-language models (VLMs). Most existing VLMs point by generating coordinates as part of their text output, which requires learning a complicated coordinate system and results in a high token count. Instead, we propose a more intuitive pointing mechanism that directly selects the visual tokens that contain the target concept. Our model generates a special pointing token that cross-attends to the input image or video tokens and selects the appropriate one. To make this model more fine-grained, we follow these pointing tokens with an additional special token that selects a fine-grained subpatch within the initially selected region, and then a third token that specifies a location within that subpatch. We further show that performance improves by generating points sequentially in a consistent order, encoding the relative position of the previously selected point, and including a special no-more-points class when selecting visual tokens. Using this method, we set a new state-of-the-art on image pointing (70.7% on PointBench), set a new state-of-the-art among fully open models on GUI pointing (61.1% on ScreenSpotPro), and improve video pointing (59.1% human preference win rate vs. a text coordinate baseline) and tracking (+6.3% gain on Molmo2Track). We additionally show that our method achieves much higher sample efficiency and discuss the qualitative differences that emerge from this design change.

Visual search is important in our daily life. The efficient allocation of visual attention is critical to effectively complete visual search tasks. Prior research has predominantly modelled the spatial allocation of visual attention in images at the pixel level, e.g. using a saliency map. However, emerging evidence shows that visual attention is guided by objects rather than pixel intensities. This paper introduces the Object-level Attention Transformer (OAT), which predicts human scanpaths as they search for a target object within a cluttered scene of distractors. OAT uses an encoder-decoder architecture. The encoder captures information about the position and appearance of the objects within an image and about the target. The decoder predicts the gaze scanpath as a sequence of object fixations, by integrating output features from both the encoder and decoder. We also propose a new positional encoding that better reflects spatial relationships between objects. We evaluated OAT on the Amazon book cover dataset and a new dataset for visual search that we collected. OAT's predicted gaze scanpaths align more closely with human gaze patterns, compared to predictions by algorithms based on spatial attention on both established metrics and a novel behavioural-based metric. Our results demonstrate the generalization ability of OAT, as it accurately predicts human scanpaths for unseen layouts and target objects.

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.

Visual attention plays a critical role when our visual system executes active visual tasks by interacting with the physical scene. However, how to encode the visual object relationship in the psychological world of our brain deserves to be explored. In the field of computer vision, predicting visual fixations or scanpaths is a usual way to explore the visual attention and behaviors of human observers when viewing a scene. Most existing methods encode visual attention using individual fixations or scanpaths based on the raw gaze shift data collected from human observers. This may not capture the common attention pattern well, because without considering the semantic information of the viewed scene, raw gaze shift data alone contain high inter- and intra-observer variability. To address this issue, we propose a new attention representation, called Attention Graph, to simultaneously code the visual saliency and scanpath in a graph-based representation and better reveal the common attention behavior of human observers. In the attention graph, the semantic-based scanpath is defined by the path on the graph, while saliency of objects can be obtained by computing fixation density on each node. Systemic experiments demonstrate that the proposed attention graph combined with our new evaluation metrics provides a better benchmark for evaluating attention prediction methods. Meanwhile, extra experiments demonstrate the promising potentials of the proposed attention graph in assessing human cognitive states, such as autism spectrum disorder screening and age classification.

A major goal of neuroscience is to understand brain computations during visual processing in naturalistic settings. A dominant approach is to use image-computable deep neural networks trained with different task objectives as a basis for linear encoding models. However, in addition to requiring tuning a large number of parameters, the linear encoding approach ignores the structure of the feature maps both in the brain and the models. Recently proposed alternatives have focused on decomposing the linear mapping to spatial and feature components but focus on finding static receptive fields for units that are applicable only in early visual areas. In this work, we employ the attention mechanism used in the transformer architecture to study how retinotopic visual features can be dynamically routed to category-selective areas in high-level visual processing. We show that this computational motif is significantly more powerful than alternative methods in predicting brain activity during natural scene viewing, across different feature basis models and modalities. We also show that this approach is inherently more interpretable, without the need to create importance maps, by interpreting the attention routing signal for different high-level categorical areas. Our approach proposes a mechanistic model of how visual information from retinotopic maps can be routed based on the relevance of the input content to different category-selective regions.

Referring expression comprehension aims to localize the object instance described by a natural language expression. Current referring expression methods have achieved good performance. However, none of them is able to achieve real-time inference without accuracy drop. The reason for the relatively slow inference speed is that these methods artificially split the referring expression comprehension into two sequential stages including proposal generation and proposal ranking. It does not exactly conform to the habit of human cognition. To this end, we propose a novel Realtime Cross-modality Correlation Filtering method (RCCF). RCCF reformulates the referring expression comprehension as a correlation filtering process. The expression is first mapped from the language domain to the visual domain and then treated as a template (kernel) to perform correlation filtering on the image feature map. The peak value in the correlation heatmap indicates the center points of the target box. In addition, RCCF also regresses a 2-D object size and 2-D offset. The center point coordinates, object size and center point offset together to form the target bounding box. Our method runs at 40 FPS while achieving leading performance in RefClef, RefCOCO, RefCOCO+ and RefCOCOg benchmarks. In the challenging RefClef dataset, our methods almost double the state-of-the-art performance (34.70% increased to 63.79%). We hope this work can arouse more attention and studies to the new cross-modality correlation filtering framework as well as the one-stage framework for referring expression comprehension.

Precise spatial modeling in the operating room (OR) is foundational to many clinical tasks, supporting intraoperative awareness, hazard avoidance, and surgical decision-making. While existing approaches leverage large-scale multimodal datasets for latent-space alignment to implicitly learn spatial relationships, they overlook the 3D capabilities of MLLMs. However, this approach raises two issues: (1) Operating rooms typically lack multiple video and audio sensors, making multimodal 3D data difficult to obtain; (2) Training solely on readily available 2D data fails to capture fine-grained details in complex scenes. To address this gap, we introduce Spatial-ORMLLM, the first large vision-language model for 3D spatial reasoning in operating rooms using only RGB modality to infer volumetric and semantic cues, enabling downstream medical tasks with detailed and holistic spatial context. Spatial-ORMLLM incorporates a Spatial-Enhanced Feature Fusion Block, which integrates 2D modality inputs with rich 3D spatial knowledge extracted by the estimation algorithm and then feeds the combined features into the visual tower. By employing a unified end-to-end MLLM framework, it combines powerful spatial features with textual features to deliver robust 3D scene reasoning without any additional expert annotations or sensor inputs. Experiments on multiple benchmark clinical datasets demonstrate that Spatial-ORMLLM achieves state-of-the-art performance and generalizes robustly to previously unseen surgical scenarios and downstream tasks.

Generative Vision-Language Models (VLMs) commonly treat bounding-box coordinates as independent output symbols, leaving numerical order and axis semantics implicit. We identify this representation as an important source of error in visual grounding. Hi-Token encodes each coordinate with axis-specific tokens for the hundreds, tens, and ones digits, which adds coarse-to-fine structure and increases token reuse while retaining the existing VLM architecture. Hi-GAR complements this representation with a geometry-based reward for Group Relative Policy Optimization (GRPO), using box overlap and coordinate accuracy at multiple scales. Controlled comparisons under matched training conditions show that Hi-Token improves localization throughout the evaluated IoU range. Hi-GAR further reduces low-overlap predictions and is used only during training. Experiments on three VLM backbones and the RefCOCO family show consistent gains across models and benchmarks. Hi-R1 achieves higher values than strong specialist baselines on most reported metrics. Analyses of token frequency, digit boundaries, object scale, and IoU distributions explain the effects of coordinate representation and reward training. The results show that structured coordinate generation provides an effective approach to generative visual grounding. Project page: https://xyzzzh.github.io/Hi-Token/

What is an image and how to extract latent features? Convolutional Networks (ConvNets) consider an image as organized pixels in a rectangular shape and extract features via convolutional operation in local region; Vision Transformers (ViTs) treat an image as a sequence of patches and extract features via attention mechanism in a global range. In this work, we introduce a straightforward and promising paradigm for visual representation, which is called Context Clusters. Context clusters (CoCs) view an image as a set of unorganized points and extract features via simplified clustering algorithm. In detail, each point includes the raw feature (e.g., color) and positional information (e.g., coordinates), and a simplified clustering algorithm is employed to group and extract deep features hierarchically. Our CoCs are convolution- and attention-free, and only rely on clustering algorithm for spatial interaction. Owing to the simple design, we show CoCs endow gratifying interpretability via the visualization of clustering process. Our CoCs aim at providing a new perspective on image and visual representation, which may enjoy broad applications in different domains and exhibit profound insights. Even though we are not targeting SOTA performance, COCs still achieve comparable or even better results than ConvNets or ViTs on several benchmarks. Codes are available at: https://github.com/ma-xu/Context-Cluster.

Medical foundation models, pre-trained with large-scale clinical data, demonstrate strong performance in diverse clinically relevant applications. RETFound, trained on nearly one million retinal images, exemplifies this approach in applications with retinal images. However, the emergence of increasingly powerful and multifold larger generalist foundation models such as DINOv2 and DINOv3 raises the question of whether domain-specific pre-training remains essential, and if so, what gap persists. To investigate this, we systematically evaluated the adaptability of DINOv2 and DINOv3 in retinal image applications, compared to two specialist RETFound models, RETFound-MAE and RETFound-DINOv2. We assessed performance on ocular disease detection and systemic disease prediction using two adaptation strategies: fine-tuning and linear probing. Data efficiency and adaptation efficiency were further analysed to characterise trade-offs between predictive performance and computational cost. Our results show that although scaling generalist models yields strong adaptability across diverse tasks, RETFound-DINOv2 consistently outperforms these generalist foundation models in ocular-disease detection and oculomics tasks, demonstrating stronger generalisability and data efficiency. These findings suggest that specialist retinal foundation models remain the most effective choice for clinical applications, while the narrowing gap with generalist foundation models suggests that continued data and model scaling can deliver domain-relevant gains and position them as strong foundations for future medical foundation models.

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).