# Response-Aware Multimodal Learning for Post-Treatment Visual Acuity Forecasting

arXiv: https://arxiv.org/abs/2606.00588 · HTML: https://mlsanity.com/paper/2606.00588/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 7 of its 20 references that are in the map.
- First posted on arXiv 30 May 2026.

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

- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Densely Connected Convolutional Networks](https://mlsanity.com/paper/1608.06993/) (2016)
- [A ConvNet for the 2020s](https://mlsanity.com/paper/2201.03545/) (2022)
- [TabTransformer: Tabular Data Modeling Using Contextual Embeddings](https://mlsanity.com/paper/2012.06678/) (2020)
- [T2G-Former: Organizing Tabular Features into Relation Graphs Promotes Heterogeneous Feature Interaction](https://mlsanity.com/paper/2211.16887/) (2022)
- [Multi-scale Feature Enhancement in Multi-task Learning for Medical Image Analysis](https://mlsanity.com/paper/2412.00351/) (2024)

## Abstract (arXiv)

Long-term visual acuity (VA) outcomes after anti-VEGF therapy are central to patient counseling, expectation setting, and follow-up planning in diabetic macular edema (DME). However, in clinical practice, physicians must often estimate long-term visual trajectories based only on early post-treatment findings, making reliable prognostication difficult. Although prior OCT-based learning approaches have largely focused on short-term response or single-endpoint prediction, modeling VA trajectories across multiple future time points from early longitudinal observations remains insufficiently explored. In this study, we assembled a real-world cohort of 188 anti-VEGF--treated DME patients with paired baseline and month-1 OCT scans, along with tabular OCT-derived biomarkers and non-imaging clinical variables. Using only these early data, we formulate a multi-horizon VA forecasting problem aimed at predicting visual outcomes at 3, 6, 12, 18, and 24 months, reflecting clinically meaningful follow-up intervals. We propose ReVA, a response-aware multimodal framework that integrates structural features from baseline and month-1 OCT with the tabular variables to capture baseline disease status and early treatment response. ReVA uses spatial attention to preserve localized prognostic imaging features and a dependency-aware tabular encoder to model interactions among clinical variables. These multimodal representations are fused to predict patient-specific long-term visual acuity trajectories. The proposed framework achieves MAE =0.1246, RMSE =0.1621, and R2=0.6064 for 24-month VA prediction, with consistent performance across all forecast horizons. Our findings show that incorporating early treatment-response signals enables clinically meaningful long-term visual acuity forecasting, supporting data-driven decision support for routine anti-VEGF management.