# Bridging the Gap in Ophthalmic AI: MM-Retinal-Reason Dataset and OphthaReason Model toward Dynamic Multimodal Reasoning

arXiv: https://arxiv.org/abs/2508.16129 · HTML: https://mlsanity.com/paper/2508.16129/

## Key facts

- Cited by 6 papers in the map (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 52 of its 74 references that are in the map.
- First posted on arXiv 22 Aug 2025.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)
- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 30 of 52)

- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [DeepSeekMath: Pushing the Limits of Mathematical Reasoning in Open Language Models](https://mlsanity.com/paper/2402.03300/) (2024)
- [Efficient Memory Management for Large Language Model Serving with PagedAttention](https://mlsanity.com/paper/2309.06180/) (2023)
- [Qwen2.5-VL Technical Report](https://mlsanity.com/paper/2502.13923/) (2025)
- [Soft Actor-Critic: Off-Policy Maximum Entropy Deep Reinforcement Learning with a Stochastic Actor](https://mlsanity.com/paper/1801.01290/) (2018)
- [Gemini 2.5: Pushing the Frontier with Advanced Reasoning, Multimodality, Long Context, and Next Generation Agentic Capabilities](https://mlsanity.com/paper/2507.06261/) (2025)
- [InternVL: Scaling up Vision Foundation Models and Aligning for Generic Visual-Linguistic Tasks](https://mlsanity.com/paper/2312.14238/) (2023)
- [Language Models (Mostly) Know What They Know](https://mlsanity.com/paper/2207.05221/) (2022)
- [InternVL3: Exploring Advanced Training and Test-Time Recipes for Open-Source Multimodal Models](https://mlsanity.com/paper/2504.10479/) (2025)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [Vision-R1: Incentivizing Reasoning Capability in Multimodal Large Language Models](https://mlsanity.com/paper/2503.06749/) (2025)
- [LLaVA-NeXT-Interleave: Tackling Multi-image, Video, and 3D in Large Multimodal Models](https://mlsanity.com/paper/2407.07895/) (2024)
- [DAB-DETR: Dynamic Anchor Boxes are Better Queries for DETR](https://mlsanity.com/paper/2201.12329/) (2022)
- [Visual-RFT: Visual Reinforcement Fine-Tuning](https://mlsanity.com/paper/2503.01785/) (2025)
- [MedGemma Technical Report](https://mlsanity.com/paper/2507.05201/) (2025)
- [Med-Flamingo: a Multimodal Medical Few-shot Learner](https://mlsanity.com/paper/2307.15189/) (2023)
- [PMC-VQA: Visual Instruction Tuning for Medical Visual Question Answering](https://mlsanity.com/paper/2305.10415/) (2023)
- [Reasoning with Exploration: An Entropy Perspective](https://mlsanity.com/paper/2506.14758/) (2025)
- [HuatuoGPT-o1, Towards Medical Complex Reasoning with LLMs](https://mlsanity.com/paper/2412.18925/) (2024)
- [Lingshu: A Generalist Foundation Model for Unified Multimodal Medical Understanding and Reasoning](https://mlsanity.com/paper/2506.07044/) (2025)
- [MedXpertQA: Benchmarking Expert-Level Medical Reasoning and Understanding](https://mlsanity.com/paper/2501.18362/) (2025)
- [HuatuoGPT-Vision, Towards Injecting Medical Visual Knowledge into Multimodal LLMs at Scale](https://mlsanity.com/paper/2406.19280/) (2024)
- [OmniMedVQA: A New Large-Scale Comprehensive Evaluation Benchmark for Medical LVLM](https://mlsanity.com/paper/2402.09181/) (2024)
- [MedVLM-R1: Incentivizing Medical Reasoning Capability of Vision-Language Models (VLMs) via Reinforcement Learning](https://mlsanity.com/paper/2502.19634/) (2025)
- [Med-R1: Reinforcement Learning for Generalizable Medical Reasoning in Vision-Language Models](https://mlsanity.com/paper/2503.13939/) (2025)
- [HealthGPT: A Medical Large Vision-Language Model for Unifying Comprehension and Generation via Heterogeneous Knowledge Adaptation](https://mlsanity.com/paper/2502.09838/) (2025)
- [Reason-RFT: Reinforcement Fine-Tuning for Visual Reasoning of Vision Language Models](https://mlsanity.com/paper/2503.20752/) (2025)
- [Perception-Aware Policy Optimization for Multimodal Reasoning](https://mlsanity.com/paper/2507.06448/) (2025)
- [GMAI-MMBench: A Comprehensive Multimodal Evaluation Benchmark Towards General Medical AI](https://mlsanity.com/paper/2408.03361/) (2024)
- [MEDEC: A Benchmark for Medical Error Detection and Correction in Clinical Notes](https://mlsanity.com/paper/2412.19260/) (2024)

## Built on by (most cited first, 6 of 6)

- [Toward Clinically Explainable AI for Medical Diagnosis: A Foundation Model with Human-Compatible Reasoning via Reinforcement Learning](https://mlsanity.com/paper/2509.03906/) (2025)
- [Fundus-R1: Training a Fundus-Reading MLLM with Knowledge-Aware Reasoning on Public Data](https://mlsanity.com/paper/2604.08322/) (2026)
- [CORE-Seg: Reasoning-Driven Segmentation for Complex Lesions via Reinforcement Learning](https://mlsanity.com/paper/2603.05911/) (2026)
- [OphIn-500K: Curating Web-Scale Visual Instructions for Scaling Ophthalmic Multimodal Large Language Models](https://mlsanity.com/paper/2605.27916/) (2026)
- [RetiBridge: Bridging Quantitative Retinal Biomarkers and Qualitative Diagnosis with a Knowledge-Guided Multimodal Large Language Model](https://mlsanity.com/paper/2510.04281/) (2025)
- [PathoSage: Towards Multi-Source Evidence Adjudication in Pathology via Experience-Aware Agentic Workflow](https://mlsanity.com/paper/2606.07549/) (2026)

## Abstract (arXiv)

Multimodal large language models (MLLMs) have recently demonstrated remarkable reasoning abilities under reinforcement learning (RL) paradigm. However, most existing multimodal medical reasoning models focus on basic reasoning, which refers to shallow inference based on visual feature matching. In contrast, real-world clinical diagnosis extends beyond basic reasoning, demanding complex reasoning that integrates heterogeneous clinical information (such as chief complaints and medical history) with multimodal medical imaging data. To bridge this gap, we introduce MM-Retinal-Reason, an ophthalmic multimodal dataset covering the full spectrum of perception and reasoning. Specifically, it is the first dataset in ophthalmology to encompass both basic and complex reasoning tasks with Chain-of-Thought (CoT) trajectories, aiming to enhance visual-centric reasoning and emulate realistic clinical decision-making. Building upon MM-Retinal-Reason, we propose OphthaReason, the first RL-enhanced ophthalmic multimodal reasoning model with step-by-step reasoning traces. To enable flexible adaptation to both basic and complex reasoning tasks, we further introduce Uncertainty-Aware Dynamic Thinking (UADT), which estimates sample-level uncertainty via entropy and dynamically modulates exploration depth through a shaped advantage mechanism. Comprehensive experiments demonstrate the effectiveness of our model on both basic and complex reasoning tasks, outperforming general-purpose MLLMs, medical MLLMs, RL-based medical MLLMs, and ophthalmic MLLMs by at least 15.47%. Project Page: hrefhttps://github.com/lxirich/OphthaReasonlink.