Triple-Phase Multimodal Knowledge Aggregation Framework for Microbial Keratitis Subtype Diagnosis on Slit-Lamp Photography

Microbial keratitis requires rapid pathogen identification to guide treatment, but culture- and PCR-based diagnostics are slow and resource-intensive. We developed a triple-phase multimodal framework for bacterial-versus-fungal keratitis classification using slit-lamp photographs acquired under blue-light, sclerotic-scatter, and white-light illumination, together with clinical metadata. The model combines cross-modality contrastive learning, modality-specific fine-tuning, and feature-level multimodal ensemble learning for patient-level prediction. We evaluated the framework on a multicenter dataset of 1,645 patients and 17,158 images from India and the United States. The model achieved 85.84% accuracy, 84.46% average F1-score, and 0.885 AUC. Site-specific evaluation showed that pooled results were overly optimistic, whereas resampling- and balance-based re-evaluation provided a more realistic assessment of cross-site generalization. Under all settings, our framework remained the top-performing approach. Upon acceptance, the code will be released and dataset access will be provided subject to University of Michigan data-sharing clearance.

Creating Realistic Anterior Segment Optical Coherence Tomography Images using Generative Adversarial Networks

This paper presents the development and validation of a Generative Adversarial Network (GAN) purposed to create high-resolution, realistic Anterior Segment Optical Coherence Tomography (AS-OCT) images. We trained the Style and WAvelet based GAN (SWAGAN) on 142,628 AS-OCT B-scans. Three experienced refractive surgeons performed a blinded assessment to evaluate the realism of the generated images; their results were not significantly better than chance in distinguishing between real and synthetic images, thus demonstrating a high degree of image realism. To gauge their suitability for machine learning tasks, a convolutional neural network (CNN) classifier was trained with a dataset containing both real and GAN-generated images. The CNN demonstrated an accuracy rate of 78% trained on real images alone, but this accuracy rose to 100% when training included the generated images. This underscores the utility of synthetic images for machine learning applications. We further improved the resolution of the generated images by up-sampling them twice (2x) using an Enhanced Super Resolution GAN (ESRGAN), which outperformed traditional up-sampling techniques. In conclusion, GANs can effectively generate high-definition, realistic AS-OCT images, proving highly beneficial for machine learning and image analysis tasks.