# Comprehensive Evaluation of OCT-based Automated Segmentation of Retinal Layer, Fluid and Hyper-Reflective Foci: Impact on Clinical Assessment of Diabetic Retinopathy Severity

arXiv: https://arxiv.org/abs/2503.01248 · HTML: https://mlsanity.com/paper/2503.01248/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 8 of its 41 references that are in the map.
- First posted on arXiv 3 Mar 2025.

## Builds on (most cited first, 8 of 8)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [SegFormer: Simple and Efficient Design for Semantic Segmentation with Transformers](https://mlsanity.com/paper/2105.15203/) (2021)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [VM-UNet: Vision Mamba UNet for Medical Image Segmentation](https://mlsanity.com/paper/2402.02491/) (2024)
- [Medical SAM 2: Segment medical images as video via Segment Anything Model 2](https://mlsanity.com/paper/2408.00874/) (2024)
- [Deep learning to achieve clinically applicable segmentation of head and neck anatomy for radiotherapy](https://mlsanity.com/paper/1809.04430/) (2018)
- [ReLayNet: Retinal Layer and Fluid Segmentation of Macular Optical Coherence Tomography using Fully Convolutional Network](https://mlsanity.com/paper/1704.02161/) (2017)
- [Segmentation-guided Domain Adaptation and Data Harmonization of Multi-device Retinal Optical Coherence Tomography using Cycle-Consistent Generative Adversarial Networks](https://mlsanity.com/paper/2208.14635/) (2022)

## Abstract (arXiv)

Diabetic retinopathy (DR) is a leading cause of vision loss, requiring early and accurate assessment to prevent irreversible damage. Spectral Domain Optical Coherence Tomography (SD-OCT) enables high-resolution retinal imaging, but automated segmentation performance varies, especially in cases with complex fluid and hyperreflective foci (HRF) patterns. This study proposes an active-learning-based deep learning pipeline for automated segmentation of retinal layers, fluid, and HRF, using four state-of-the-art models: U-Net, SegFormer, SwinUNETR, and VM-UNet, trained on expert-annotated SD-OCT volumes. Segmentation accuracy was evaluated with five-fold cross-validation, and retinal thickness was quantified using a K-nearest neighbors algorithm and visualized with Early Treatment Diabetic Retinopathy Study (ETDRS) maps. SwinUNETR achieved the highest overall accuracy (DSC = 0.7719; NSD = 0.8149), while VM-UNet excelled in specific layers. Structural differences were observed between non-proliferative and proliferative DR, with layer-specific thickening correlating with visual acuity impairment. The proposed framework enables robust, clinically relevant DR assessment while reducing the need for manual annotation, supporting improved disease monitoring and treatment planning.