# DenseUNets with feedback non-local attention for the segmentation of specular microscopy images of the corneal endothelium with guttae

arXiv: https://arxiv.org/abs/2203.01882 · HTML: https://mlsanity.com/paper/2203.01882/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 10 of its 52 references that are in the map.
- First posted on arXiv 3 Mar 2022.

## Builds on (most cited first, 10 of 10)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Aggregated Residual Transformations for Deep Neural Networks](https://mlsanity.com/paper/1611.05431/) (2016)
- [Non-local Neural Networks](https://mlsanity.com/paper/1711.07971/) (2017)
- [Attention U-Net: Learning Where to Look for the Pancreas](https://mlsanity.com/paper/1804.03999/) (2018)
- [Fast and Accurate Deep Network Learning by Exponential Linear Units (ELUs)](https://mlsanity.com/paper/1511.07289/) (2015)
- [UNet++: Redesigning Skip Connections to Exploit Multiscale Features in Image Segmentation](https://mlsanity.com/paper/1912.05074/) (2019)
- [Bottleneck Transformers for Visual Recognition](https://mlsanity.com/paper/2101.11605/) (2021)
- [Batch Renormalization: Towards Reducing Minibatch Dependence in Batch-Normalized Models](https://mlsanity.com/paper/1702.03275/) (2017)
- [The One Hundred Layers Tiramisu: Fully Convolutional DenseNets for Semantic Segmentation](https://mlsanity.com/paper/1611.09326/) (2016)

## Built on by (most cited first, 1 of 1)

- [Corneal endothelium assessment in specular microscopy images with Fuchs' dystrophy via deep regression of signed distance maps](https://mlsanity.com/paper/2210.07102/) (2022)

## Abstract (arXiv)

To estimate the corneal endothelial parameters from specular microscopy images depicting cornea guttata (Fuchs dystrophy), we propose a new deep learning methodology that includes a novel attention mechanism named feedback non-local attention (fNLA). Our approach first infers the cell edges, then selects the cells that are well detected, and finally applies a postprocessing method to correct mistakes and provide the binary segmentation from which the corneal parameters are estimated (cell density [ECD], coefficient of variation [CV], and hexagonality [HEX]). In this study, we analyzed 1203 images acquired with a Topcon SP-1P microscope, 500 of which contained guttae. Manual segmentation was performed in all images. We compared the results of different networks (UNet, ResUNeXt, DenseUNets, UNet++) and found that DenseUNets with fNLA provided the best performance, with a mean absolute error of 23.16 [cells/mm2] in ECD, 1.28 [%] in CV, and 3.13 [%] in HEX, which was 3-6 times smaller than the error obtained by Topcon's built-in software. Our approach handled the cells affected by guttae remarkably well, detecting cell edges occluded by small guttae while discarding areas covered by large guttae. Overall, the proposed method obtained accurate estimations in extremely challenging specular images.