UT-Net: Combining U-Net and Transformer for Joint Optic Disc and Cup Segmentation and Glaucoma Detection

Glaucoma is a chronic visual disease that may cause permanent irreversible blindness. Measurement of the cup-to-disc ratio (CDR) plays a pivotal role in the detection of glaucoma in its early stage, preventing visual disparities. Therefore, accurate and automatic segmentation of optic disc (OD) and optic cup (OC) from retinal fundus images is a fundamental requirement. Existing CNN-based segmentation frameworks resort to building deep encoders with aggressive downsampling layers, which suffer from a general limitation on modeling explicit long-range dependency. To this end, in this paper, we propose a new segmentation pipeline, called UT-Net, availing the advantages of U-Net and transformer both in its encoding layer, followed by an attention-gated bilinear fusion scheme. In addition to this, we incorporate Multi-Head Contextual attention to enhance the regular self-attention used in traditional vision transformers. Thus low-level features along with global dependencies are captured in a shallow manner. Besides, we extract context information at multiple encoding layers for better exploration of receptive fields, and to aid the model to learn deep hierarchical representations. Finally, an enhanced mixing loss is proposed to tightly supervise the overall learning process. The proposed model has been implemented for joint OD and OC segmentation on three publicly available datasets: DRISHTI-GS, RIM-ONE R3, and REFUGE. Additionally, to validate our proposal, we have performed exhaustive experimentation on Glaucoma detection from all three datasets by measuring the Cup to Disc Ratio (CDR) value. Experimental results demonstrate the superiority of UT-Net as compared to the state-of-the-art methods.