GCVAMD: A Modified CausalVAE Model for Causal Age-related Macular Degeneration Risk Factor Detection and Prediction

Age Related Macular Degeneration(AMD) has been one of the most leading causes of permanent vision impairment in ophthalmology. Though treatments, such as anti VEGF drugs or photodynamic therapies, were developed to slow down the degenerative process of AMD, there is still no specific cure to reverse vision loss caused by AMD. Thus, for AMD, detecting existence of risk factors of AMD or AMD itself within the patient retina in early stages is a crucial task to reduce the possibility of vision impairment. Apart from traditional approaches, deep learning based methods, especially attention mechanism based CNNs and GradCAM based XAI analysis on OCT scans, exhibited successful performance in distinguishing AMD retina from normal retinas, making it possible to use AI driven models to aid medical diagnosis and analysis by ophthalmologists regarding AMD. However, though having significant success, previous works mostly focused on prediction performance itself, not pathologies or underlying causal mechanisms of AMD, which can prohibit intervention analysis on specific factors or even lead to less reliable decisions. Thus, this paper introduces a novel causal AMD analysis model: GCVAMD, which incorporates a modified CausalVAE approach that can extract latent causal factors from only raw OCT images. By considering causality in AMD detection, GCVAMD enables causal inference such as treatment simulation or intervention analysis regarding major risk factors: drusen and neovascularization, while returning informative latent causal features that can enhance downstream tasks. Results show that through GCVAMD, drusen status and neovascularization status can be identified with AMD causal mechanisms in GCVAMD latent spaces, which can in turn be used for various tasks from AMD detection(classification) to intervention analysis.