PRETI: Patient-Aware Retinal Foundation Model via Metadata-Guided Representation Learning

Retinal foundation models have significantly advanced retinal image analysis by leveraging self-supervised learning to reduce dependence on labeled data while achieving strong generalization. Many recent approaches enhance retinal image understanding using report supervision, but obtaining clinical reports is often costly and challenging. In contrast, metadata (e.g., age, gender) is widely available and serves as a valuable resource for analyzing disease progression. To effectively incorporate patient-specific information, we propose PRETI, a retinal foundation model that integrates metadata-aware learning with robust self-supervised representation learning. We introduce Learnable Metadata Embedding (LME), which dynamically refines metadata representations. Additionally, we construct patient-level data pairs, associating images from the same individual to improve robustness against non-clinical variations. To further optimize retinal image representation, we propose Retina-Aware Adaptive Masking (RAAM), a strategy that selectively applies masking within the retinal region and dynamically adjusts the masking ratio during training. PRETI captures both global structures and fine-grained pathological details, resulting in superior diagnostic performance. Extensive experiments demonstrate that PRETI achieves state-of-the-art results across diverse diseases and biomarker predictions using in-house and public data, indicating the importance of metadata-guided foundation models in retinal disease analysis. Our code and pretrained model are available at https://github.com/MICV-yonsei/PRETI

Rethinking Glaucoma Calibration: Voting-Based Binocular and Metadata Integration

Glaucoma is an incurable ophthalmic disease that damages the optic nerve, leads to vision loss, and ranks among the leading causes of blindness worldwide. Diagnosing glaucoma typically involves fundus photography, optical coherence tomography (OCT), and visual field testing. However, the high cost of OCT often leads to reliance on fundus photography and visual field testing, both of which exhibit inherent inter-observer variability. This stems from glaucoma being a multifaceted disease that influenced by various factors. As a result, glaucoma diagnosis is highly subjective, emphasizing the necessity of calibration, which aligns predicted probabilities with actual disease likelihood. Proper calibration is essential to prevent overdiagnosis or misdiagnosis, which are critical concerns for high-risk diseases. Although AI has significantly improved diagnostic accuracy, overconfidence in models have worsen calibration performance. Recent study has begun focusing on calibration for glaucoma. Nevertheless, previous study has not fully considered glaucoma's systemic nature and the high subjectivity in its diagnostic process. To overcome these limitations, we propose V-ViT (Voting-based ViT), a novel framework that enhances calibration by incorporating disease-specific characteristics. V-ViT integrates binocular data and metadata, reflecting the multi-faceted nature of glaucoma diagnosis. Additionally, we introduce a MC dropout-based Voting System to address high subjectivity. Our approach achieves state-of-the-art performance across all metrics, including accuracy, demonstrating that our proposed methods are effective in addressing calibration issues. We validate our method using a custom dataset including binocular data.