# AI-CNet3D: An Anatomically-Informed Cross-Attention Network with Multi-Task Consistency Fine-tuning for 3D Glaucoma Classification

arXiv: https://arxiv.org/abs/2510.00882 · HTML: https://mlsanity.com/paper/2510.00882/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 32 of its 53 references that are in the map.
- First posted on arXiv 1 Oct 2025.

## Builds on (most cited first, 30 of 32)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [A Simple Framework for Contrastive Learning of Visual Representations](https://mlsanity.com/paper/2002.05709/) (2020)
- [Communication-Efficient Learning of Deep Networks from Decentralized Data](https://mlsanity.com/paper/1602.05629/) (2016)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [Squeeze-and-Excitation Networks](https://mlsanity.com/paper/1709.01507/) (2017)
- [Bootstrap your own latent: A new approach to self-supervised Learning](https://mlsanity.com/paper/2006.07733/) (2020)
- [Mamba: Linear-Time Sequence Modeling with Selective State Spaces](https://mlsanity.com/paper/2312.00752/) (2023)
- [Efficiently Modeling Long Sequences with Structured State Spaces](https://mlsanity.com/paper/2111.00396/) (2021)
- [Learning Deep Features for Discriminative Localization](https://mlsanity.com/paper/1512.04150/) (2015)
- [Visualizing and Understanding Convolutional Networks](https://mlsanity.com/paper/1311.2901/) (2013)
- [Is Space-Time Attention All You Need for Video Understanding?](https://mlsanity.com/paper/2102.05095/) (2021)
- [Swin-Unet: Unet-like Pure Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2105.05537/) (2021)
- [Multi-Scale Context Aggregation by Dilated Convolutions](https://mlsanity.com/paper/1511.07122/) (2015)
- [CrossViT: Cross-Attention Multi-Scale Vision Transformer for Image Classification](https://mlsanity.com/paper/2103.14899/) (2021)
- [Quantifying Attention Flow in Transformers](https://mlsanity.com/paper/2005.00928/) (2020)
- [Transformer Interpretability Beyond Attention Visualization](https://mlsanity.com/paper/2012.09838/) (2020)
- [MedCLIP: Contrastive Learning from Unpaired Medical Images and Text](https://mlsanity.com/paper/2210.10163/) (2022)
- [Self-Supervised Pre-Training of Swin Transformers for 3D Medical Image Analysis](https://mlsanity.com/paper/2111.14791/) (2021)
- [Med3D: Transfer Learning for 3D Medical Image Analysis](https://mlsanity.com/paper/1904.00625/) (2019)
- [UNETR++: Delving into Efficient and Accurate 3D Medical Image Segmentation](https://mlsanity.com/paper/2212.04497/) (2022)
- [Attention Based Glaucoma Detection: A Large-scale Database and CNN Model](https://mlsanity.com/paper/1903.10831/) (2019)
- [SwiftFormer: Efficient Additive Attention for Transformer-based Real-time Mobile Vision Applications](https://mlsanity.com/paper/2303.15446/) (2023)
- [Volumetric Attention for 3D Medical Image Segmentation and Detection](https://mlsanity.com/paper/2004.01997/) (2020)
- [Brain Tumor Segmentation and Survival Prediction using 3D Attention UNet](https://mlsanity.com/paper/2104.00985/) (2021)
- [Sharpen Focus: Learning with Attention Separability and Consistency](https://mlsanity.com/paper/1811.07484/) (2018)
- [Unsupervised Deep Metric Learning with Transformed Attention Consistency and Contrastive Clustering Loss](https://mlsanity.com/paper/2008.04378/) (2020)
- [Harvard Glaucoma Detection and Progression: A Multimodal Multitask Dataset and Generalization-Reinforced Semi-Supervised Learning](https://mlsanity.com/paper/2308.13411/) (2023)
- [A feature agnostic approach for glaucoma detection in OCT volumes](https://mlsanity.com/paper/1807.04855/) (2018)
- [Attention Mechanisms in Medical Image Segmentation: A Survey](https://mlsanity.com/paper/2305.17937/) (2023)

## Abstract (arXiv)

Glaucoma is a progressive eye disease that leads to optic nerve damage, causing irreversible vision loss if left untreated. Optical coherence tomography (OCT) has become a crucial tool for glaucoma diagnosis, offering high-resolution 3D scans of the retina and optic nerve. However, the conventional practice of condensing information from 3D OCT volumes into 2D reports often results in the loss of key structural details. To address this, we propose a novel hybrid deep learning model that integrates cross-attention mechanisms into a 3D convolutional neural network (CNN), enabling the extraction of critical features from the superior and inferior hemiretinas, as well as from the optic nerve head (ONH) and macula, within OCT volumes. We introduce Channel Attention REpresentations (CAREs) to visualize cross-attention outputs and leverage them for consistency-based multi-task fine-tuning, aligning them with Gradient-Weighted Class Activation Maps (Grad-CAMs) from the CNN's final convolutional layer to enhance performance, interpretability, and anatomical coherence. We have named this model AI-CNet3D (AI-`See'-Net3D) to reflect its design as an Anatomically-Informed Cross-attention Network operating on 3D data. By dividing the volume along two axes and applying cross-attention, our model enhances glaucoma classification by capturing asymmetries between the hemiretinal regions while integrating information from the optic nerve head and macula. We validate our approach on two large datasets, showing that it outperforms state-of-the-art attention and convolutional models across all key metrics. Finally, our model is computationally efficient, reducing the parameter count by one-hundred--fold compared to other attention mechanisms while maintaining high diagnostic performance and comparable GFLOPS.