ROFI: A Deep Learning-Based Ophthalmic Sign-Preserving and Reversible Patient Face Anonymizer

Patient face images provide a convenient mean for evaluating eye diseases, while also raising privacy concerns. Here, we introduce ROFI, a deep learning-based privacy protection framework for ophthalmology. Using weakly supervised learning and neural identity translation, ROFI anonymizes facial features while retaining disease features (over 98\% accuracy, $κ> 0.90$). It achieves 100\% diagnostic sensitivity and high agreement ($κ> 0.90$) across eleven eye diseases in three cohorts, anonymizing over 95\% of images. ROFI works with AI systems, maintaining original diagnoses ($κ> 0.80$), and supports secure image reversal (over 98\% similarity), enabling audits and long-term care. These results show ROFI's effectiveness of protecting patient privacy in the digital medicine era.