SAM2LoRA: Composite Loss-Guided, Parameter-Efficient Finetuning of SAM2 for Retinal Fundus Segmentation

We propose SAM2LoRA, a parameter-efficient fine-tuning strategy that adapts the Segment Anything Model 2 (SAM2) for fundus image segmentation. SAM2 employs a masked autoencoder-pretrained Hierarchical Vision Transformer for multi-scale feature decoding, enabling rapid inference in low-resource settings; however, fine-tuning remains challenging. To address this, SAM2LoRA integrates a low-rank adapter into both the image encoder and mask decoder, requiring fewer than 5\% of the original trainable parameters. Our analysis indicates that for cross-dataset fundus segmentation tasks, a composite loss function combining segmentationBCE, SoftDice, and FocalTversky losses is essential for optimal network tuning. Evaluated on 11 challenging fundus segmentation datasets, SAM2LoRA demonstrates high performance in both blood vessel and optic disc segmentation under cross-dataset training conditions. It achieves Dice scores of up to 0.86 and 0.93 for blood vessel and optic disc segmentation, respectively, and AUC values of up to 0.98 and 0.99, achieving state-of-the-art performance while substantially reducing training overhead.