Clinical Insight-Augmented Multi-View Learning for Alzheimer’s Detection in Retinal OCTA Images

Alzheimer’s disease (AD) poses a significant global challenge, with a notable absence of accessible and cost-effective diagnostic tools for widespread AD detection. The retina, mirroring the brain in anatomy and physiology, has emerged as a potential avenue for rapid AD identification through retinal imaging. The current retinal image-based AD detection methods usually focus primarily on the macular area, but ignore the potential value that the optic disc region may have for the detection task. In this study, we leverage both macular- and disc-centered OCTA images and propose a multi-region fusion framework for AD detection. Based on clinical evidence, we integrate handcrafted features into the framework to improve model performance and interpretability. Specifically, vascular morphological parameters extracted from the macular and disc regions are used as input to a revalued KNN model to improve predictive capabilities. Furthermore, recognizing the significance of extracting and utilizing complementary information from the macular and optic disc regions, we propose an uncertainty-guided strategy based on Dempster-Shefer Theory (DST) to fuse knowledge from different regions. This approach considers each region’s forecast quality and significantly improves the effectiveness and robustness of the model. Through comparative analysis with existing methods, we have demonstrated that our method outperforms the state-of-the-art ones and provides more valuable pathological evidence for the association between retinal vascular changes and AD.