Multi-modal representation learning in retinal imaging using self-supervised learning for enhanced clinical predictions

Self-supervised learning has become the cornerstone of building generalizable and transferable artificial intelligence systems in medical imaging. In particular, contrastive representation learning techniques trained on large multi-modal datasets have demonstrated impressive capabilities of producing highly transferable representations for different downstream tasks. In ophthalmology, large multi-modal datasets are abundantly available and conveniently accessible as modern retinal imaging scanners acquire both 2D fundus images and 3D optical coherence tomography (OCT) scans to assess the eye. In this context, we introduce a novel multi-modal contrastive learning-based pipeline to facilitate learning joint representations for the two retinal imaging modalities. After self-supervised pre-training on 153,306 scan pairs, we show that such a pre-training framework can provide both a retrieval system and encoders that produce comprehensive OCT and fundus image representations that generalize well for various downstream tasks on three independent external datasets, explicitly focusing on clinically pertinent prediction tasks. In addition, we show that interchanging OCT with lower-cost fundus imaging can preserve the predictive power of the trained models.