# FunduSegmenter: Leveraging the RETFound Foundation Model for Joint Optic Disc and Optic Cup Segmentation in Retinal Fundus Images

arXiv: https://arxiv.org/abs/2508.11354 · HTML: https://mlsanity.com/paper/2508.11354/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 19 of its 51 references that are in the map.
- First posted on arXiv 15 Aug 2025.

## Builds on (most cited first, 19 of 19)

- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Very Deep Convolutional Networks for Large-Scale Image Recognition](https://mlsanity.com/paper/1409.1556/) (2014)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [MobileNetV2: Inverted Residuals and Linear Bottlenecks](https://mlsanity.com/paper/1801.04381/) (2018)
- [CBAM: Convolutional Block Attention Module](https://mlsanity.com/paper/1807.06521/) (2018)
- [BEiT: BERT Pre-Training of Image Transformers](https://mlsanity.com/paper/2106.08254/) (2021)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [Rethinking Semantic Segmentation from a Sequence-to-Sequence Perspective with Transformers](https://mlsanity.com/paper/2012.15840/) (2020)
- [Unified Perceptual Parsing for Scene Understanding](https://mlsanity.com/paper/1807.10221/) (2018)
- [SimMIM: A Simple Framework for Masked Image Modeling](https://mlsanity.com/paper/2111.09886/) (2021)
- [Segmenter: Transformer for Semantic Segmentation](https://mlsanity.com/paper/2105.05633/) (2021)
- [MONAI: An open-source framework for deep learning in healthcare](https://mlsanity.com/paper/2211.02701/) (2022)
- [REFUGE Challenge: A Unified Framework for Evaluating Automated Methods for Glaucoma Assessment from Fundus Photographs](https://mlsanity.com/paper/1910.03667/) (2019)
- [DoFE: Domain-oriented Feature Embedding for Generalizable Fundus Image Segmentation on Unseen Datasets](https://mlsanity.com/paper/2010.06208/) (2020)
- [Uniform Masking: Enabling MAE Pre-training for Pyramid-based Vision Transformers with Locality](https://mlsanity.com/paper/2205.10063/) (2022)
- [Revisiting MAE pre-training for 3D medical image segmentation](https://mlsanity.com/paper/2410.23132/) (2024)
- [When Unseen Domain Generalization is Unnecessary? Rethinking Data Augmentation](https://mlsanity.com/paper/1906.03347/) (2019)
- [Generalizable Medical Image Segmentation via Random Amplitude Mixup and Domain-Specific Image Restoration](https://mlsanity.com/paper/2208.03901/) (2022)
- [TVConv: Efficient Translation Variant Convolution for Layout-aware Visual Processing](https://mlsanity.com/paper/2203.10489/) (2022)

## Abstract (arXiv)

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.