# Bridging Restoration and Diagnosis: A Comprehensive Benchmark for Retinal Fundus Enhancement

arXiv: https://arxiv.org/abs/2604.03806 · HTML: https://mlsanity.com/paper/2604.03806/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 28 of its 47 references that are in the map.
- First posted on arXiv 4 Apr 2026.

## Builds on (most cited first, 28 of 28)

- [Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2006.11239/) (2020)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [High-Resolution Image Synthesis with Latent Diffusion Models](https://mlsanity.com/paper/2112.10752/) (2021)
- [Denoising Diffusion Implicit Models](https://mlsanity.com/paper/2010.02502/) (2020)
- [Image-to-Image Translation with Conditional Adversarial Networks](https://mlsanity.com/paper/1611.07004/) (2016)
- [Generative Modeling by Estimating Gradients of the Data Distribution](https://mlsanity.com/paper/1907.05600/) (2019)
- [Improved Training of Wasserstein GANs](https://mlsanity.com/paper/1704.00028/) (2017)
- [Least Squares Generative Adversarial Networks](https://mlsanity.com/paper/1611.04076/) (2016)
- [Contrastive Learning for Unpaired Image-to-Image Translation](https://mlsanity.com/paper/2007.15651/) (2020)
- [FreeU: Free Lunch in Diffusion U-Net](https://mlsanity.com/paper/2309.11497/) (2023)
- [The Contextual Loss for Image Transformation with Non-Aligned Data](https://mlsanity.com/paper/1803.02077/) (2018)
- [Unpaired Image-to-Image Translation via Neural Schr"odinger Bridge](https://mlsanity.com/paper/2305.15086/) (2023)
- [Evaluation of Retinal Image Quality Assessment Networks in Different Color-spaces](https://mlsanity.com/paper/1907.05345/) (2019)
- [Can Push-forward Generative Models Fit Multimodal Distributions?](https://mlsanity.com/paper/2206.14476/) (2022)
- [RET-CLIP: A Retinal Image Foundation Model Pre-trained with Clinical Diagnostic Reports](https://mlsanity.com/paper/2405.14137/) (2024)
- [Optimal Transport for Unsupervised Denoising Learning](https://mlsanity.com/paper/2108.02574/) (2021)
- [RFormer: Transformer-based Generative Adversarial Network for Real Fundus Image Restoration on A New Clinical Benchmark](https://mlsanity.com/paper/2201.00466/) (2022)
- [Study Group Learning: Improving Retinal Vessel Segmentation Trained with Noisy Labels](https://mlsanity.com/paper/2103.03451/) (2021)
- [Degradation-invariant Enhancement of Fundus Images via Pyramid Constraint Network](https://mlsanity.com/paper/2210.09606/) (2022)
- [Structure-consistent Restoration Network for Cataract Fundus Image Enhancement](https://mlsanity.com/paper/2206.04684/) (2022)
- [OTRE: Where Optimal Transport Guided Unpaired Image-to-Image Translation Meets Regularization by Enhancing](https://mlsanity.com/paper/2302.03003/) (2023)
- [Optimal Transport Guided Unsupervised Learning for Enhancing low-quality Retinal Images](https://mlsanity.com/paper/2302.02991/) (2023)
- [CUNSB-RFIE: Context-aware Unpaired Neural Schr"odinger Bridge in Retinal Fundus Image Enhancement](https://mlsanity.com/paper/2409.10966/) (2024)
- [nnMobileNet: Rethinking CNN for Retinopathy Research](https://mlsanity.com/paper/2306.01289/) (2023)
- [Self-Supervised Equivariant Regularization Reconciles Multiple Instance Learning: Joint Referable Diabetic Retinopathy Classification and Lesion Segmentation](https://mlsanity.com/paper/2210.05946/) (2022)
- [A Generic Fundus Image Enhancement Network Boosted by Frequency Self-supervised Representation Learning](https://mlsanity.com/paper/2309.00885/) (2023)
- [Context-Aware Optimal Transport Learning for Retinal Fundus Image Enhancement](https://mlsanity.com/paper/2409.07862/) (2024)
- [TPOT: Topology Preserving Optimal Transport in Retinal Fundus Image Enhancement](https://mlsanity.com/paper/2411.01403/) (2024)

## Abstract (arXiv)

Over the past decade, generative models have demonstrated success in enhancing fundus images. However, the evaluation of these models remains a challenge. A benchmark for fundus image enhancement is needed for three main reasons:(1) Conventional denoising metrics such as PSNR and SSIM fail to capture clinically relevant features, such as lesion preservation and vessel morphology consistency, limiting their applicability in real-world settings; (2) There is a lack of unified evaluation protocols that address both paired and unpaired enhancement methods, particularly those guided by clinical expertise; and (3) An evaluation framework should provide actionable insights to guide future advancements in clinically aligned enhancement models. To address these gaps, we introduce EyeBench-V2, a benchmark designed to bridge the gap between enhancement model performance and clinical utility. Our work offers three key contributions:(1) Multi-dimensional clinical-alignment through downstream evaluations: Beyond standard enhancement metrics, we assess performance across clinically meaningful tasks including vessel segmentation, diabetic retinopathy (DR) grading, generalization to unseen noise patterns, and lesion segmentation. (2) Expert-guided evaluation design: We curate a novel dataset enabling fair comparisons between paired and unpaired enhancement methods, accompanied by a structured manual assessment protocol by medical experts, which evaluates clinically critical aspects such as lesion structure alterations, background color shifts, and the introduction of artificial structures. (3) Actionable insights: Our benchmark provides a rigorous, task-oriented analysis of existing generative models, equipping clinical researchers with the evidence needed to make informed decisions, while also identifying limitations in current methods to inform the design of next-generation enhancement models.