用解剖结构约束提升OCT眼底病变与层分割的准确性和可信度

Optical coherence tomography (OCT) is widely used for diagnosing and monitoring retinal diseases, such as age-related macular degeneration (AMD). The segmentation of biomarkers such as layers and lesions is essential for patient diagnosis and follow-up. Recently, semi-supervised learning has shown promise in improving retinal segmentation performance. However, existing methods often produce anatomically implausible segmentations, fail to effectively model layer-lesion interactions, and lack guarantees on topological correctness. To address these limitations, we propose a novel semi-supervised model that introduces a fully differentiable biomarker topology engine to enforce anatomically correct segmentation of lesions and layers. This enables joint learning with bidirectional influence between layers and lesions, leveraging unlabeled and diverse partially labeled datasets. Our model learns a disentangled representation, separating spatial and style factors. This approach enables more realistic layer segmentations and improves lesion segmentation, while strictly enforcing lesion location in their anatomically plausible positions relative to the segmented layers. We evaluate the proposed model on public and internal datasets of OCT scans and show that it outperforms the current state-of-the-art in both lesion and layer segmentation, while demonstrating the ability to generalize layer segmentation to pathological cases using partially annotated training data. Our results demonstrate the potential of using anatomical constraints in semi-supervised learning for accurate, robust, and trustworthy retinal biomarker segmentation.