# TRIAGE: Risk-Controlled Pseudo-Label Admission for Annotation-Efficient Semi-Supervised Retinal OCT Classification

arXiv: https://arxiv.org/abs/2608.14321 · HTML: https://mlsanity.com/paper/2608.14321/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 14 of its 60 references that are in the map.
- First posted on arXiv 14 Aug 2026.

## Builds on (most cited first, 14 of 14)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [EfficientNet: Rethinking Model Scaling for Convolutional Neural Networks](https://mlsanity.com/paper/1905.11946/) (2019)
- [RandAugment: Practical automated data augmentation with a reduced search space](https://mlsanity.com/paper/1909.13719/) (2019)
- [FixMatch: Simplifying Semi-Supervised Learning with Consistency and Confidence](https://mlsanity.com/paper/2001.07685/) (2020)
- [FlexMatch: Boosting Semi-Supervised Learning with Curriculum Pseudo Labeling](https://mlsanity.com/paper/2110.08263/) (2021)
- [FreeMatch: Self-adaptive Thresholding for Semi-supervised Learning](https://mlsanity.com/paper/2205.07246/) (2022)
- [Not-so-supervised: a survey of semi-supervised, multi-instance, and transfer learning in medical image analysis](https://mlsanity.com/paper/1804.06353/) (2018)
- [CoMatch: Semi-supervised Learning with Contrastive Graph Regularization](https://mlsanity.com/paper/2011.11183/) (2020)
- [Learning with Limited Annotations: A Survey on Deep Semi-Supervised Learning for Medical Image Segmentation](https://mlsanity.com/paper/2207.14191/) (2022)
- [Multi-Scale Convolutional Neural Network for Automated AMD Classification using Retinal OCT Images](https://mlsanity.com/paper/2110.03002/) (2021)
- [SegMatch: A semi-supervised learning method for surgical instrument segmentation](https://mlsanity.com/paper/2308.05232/) (2023)
- [Shifting to Machine Supervision: Annotation-Efficient Semi and Self-Supervised Learning for Automatic Medical Image Segmentation and Classification](https://mlsanity.com/paper/2311.10319/) (2023)
- [Dual Cross-image Semantic Consistency with Self-aware Pseudo Labeling for Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/2507.21440/) (2025)

## Abstract (arXiv)

The advanced retinal disease diagnosing imaging modality, optical coherence tomography (OCT), encounters a lack of automation because of the high expenses for annotations performed by specialists. The use of SSL solves the problem of insufficient annotations using unlabeled B-scans; however, most of the current techniques for generating pseudo-labels are based on prediction confidence without considering the asymmetry between different types of errors. This paper proposes TRIAGE, a risk-controlled semi-supervised framework for OCT scans classification, which uses the concept of a patient-level conformal risk controller with an asymmetric cost matrix. TRIAGE unites three crucial modules: a hierarchical classifier that is capable of working with partially abnormal supervision of the disease subtypes, a patient-grouped conformal risk controller with primal-dual coverage control, and a context-aware Transformer teacher for cross-slice verification. On the dataset from Noor Eye Hospital (16,822 B-scans, 161 patients, and 554 volumes) with a test set of unseen patients, TRIAGE demonstrates 89.66% scan-level accuracy, 0.8805 macro-F1, 0.9641 macro-AUC, and an 8.34% under-grading rate when using only 20% of the labeled data. With only 5% of the labeled data, TRIAGE keeps 76.88% accuracy and a 0.1656 under-grading rate. Compared with the other six state-of-the-art semi-supervised methods, TRIAGE significantly outperforms them with ablation study demonstrating the contribution of each module in the overall framework performance (by 42.7% in terms of under-grading rate comparing to fixed threshold methods). TRIAGE demonstrates 98.00% accuracy for 3-class classification with 1% labeled data and 95.94% accuracy for 8-class classification with 10% labeled data on the OCT-C8 dataset.