C2FTFNet: Coarse-to-fine transformer network for joint optic disc and cup segmentation

Glaucoma is a leading cause of worldwide blindness and visual impairment, making early screening and diagnosis is crucial to prevent vision loss. Cup-to-Disk Ratio (CDR) evaluation serves as a widely applied approach for effective glaucoma screening. At present, deep learning methods have exhibited outstanding performance in optic disk (OD) and optic cup (OC) segmentation and maturely deployed in CAD system. However, owning to the complexity of clinical data, these techniques could be constrained. Therefore, an original Coarse-to-Fine Transformer Network (C2FTFNet) is designed to segment OD and OC jointly , which is composed of two stages. In the coarse stage, to eliminate the effects of irrelevant organization on the segmented OC and OD regions, we employ U-Net and Circular Hough Transform (CHT) to segment the Region of Interest (ROI) of OD. Meanwhile, a TransUnet3+ model is designed in the fine segmentation stage to extract the OC and OD regions more accurately from ROI. In this model, to alleviate the limitation of the receptive field caused by traditional convolutional methods, a Transformer module is introduced into the backbone to capture long-distance dependent features for retaining more global information. Then, a Multi-Scale Dense Skip Connection (MSDC) module is proposed to fuse the low-level and high-level features from different layers for reducing the semantic gap among different level features. Comprehensive experiments conducted on DRIONS-DB, Drishti-GS, and REFUGE datasets validate the superior effectiveness of the proposed C2FTFNet compared to existing state-of-theart approaches.

Automated summary

Glaucoma, a leading cause of blindness and visual impairment globally, requires early screening and diagnosis to prevent vision loss. Deep learning methods have shown promising results in optic disk and optic cup segmentation and have been incorporated into CAD systems. However, the complexity of clinical data poses challenges. In this study, a novel Coarse-to-Fine Transformer Network (C2FTFNet) is proposed to jointly segment the optic disk and optic cup, utilizing U-Net, Circular Hough Transform, TransUnet3+, Transformer module, and Multi-Scale Dense Skip Connection. Experimental results on multiple datasets validate the superior effectiveness of C2FTFNet compared to existing approaches.