# TAPE: A two-stage parameter-efficient adaptation framework for foundation models in OCT-OCTA analysis

arXiv: https://arxiv.org/abs/2604.04571 · HTML: https://mlsanity.com/paper/2604.04571/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 7 of its 16 references that are in the map.
- First posted on arXiv 6 Apr 2026.

## Builds on (most cited first, 7 of 7)

- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [Visual Prompt Tuning](https://mlsanity.com/paper/2203.12119/) (2022)
- [Vision Transformer Adapter for Dense Predictions](https://mlsanity.com/paper/2205.08534/) (2022)
- [OCTA-500: A Retinal Dataset for Optical Coherence Tomography Angiography Study](https://mlsanity.com/paper/2012.07261/) (2020)
- [ReLayNet: Retinal Layer and Fluid Segmentation of Macular Optical Coherence Tomography using Fully Convolutional Network](https://mlsanity.com/paper/1704.02161/) (2017)
- [Multi-scale GCN-assisted two-stage network for joint segmentation of retinal layers and disc in peripapillary OCT images](https://mlsanity.com/paper/2102.04799/) (2021)

## Abstract (arXiv)

Automated analysis of optical coherence tomography (OCT) and OCT angiography (OCTA) images is critical for robust ophthalmic diagnosis. Existing mainstream methods trained from scratch rely heavily on massive data and model scale, thereby hindering their practical deployment in resource-constrained clinical settings. Although transfer learning based on foundation models (FMs) is promising, it still faces significant challenges: domain shift and task misalignment. To address these, we propose TAPE: A Two-stage Adaptation Framework via Parameter-Efficient Fine-tuning, which strategically decouples adaptation into domain alignment and task fitting for downstream segmentation. The domain adaptation stage notably applies parameter-efficient fine-tuning (PEFT) in the context of masked image modeling for medical image domain adaptation, a novel approach to the best of our knowledge. Applying TAPE to retinal layer segmentation on both universal (masked auto-encoder, MAE) and specialized (RETFound) FMs, it demonstrates superior parameter efficiency and achieves state-of-the-art generalization performance across diverse pathologies.