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Compact Vision-Language Models Enable Efficient and Interpretable Automated OCT Analysis Through Layer Specific
Tania Haghighi1, Sina Gholami1, Jared Todd Sokol2
1Department of Electrical and Computer Engineering, University of North Carolina at Charlotte, Charlotte, NC 28223, USA.
Biorxiv : the Preprint Server for Biology
|August 20, 2025
Summary
We developed LO-VLM, an efficient AI model for interpreting OCT B-scans, to generate accurate clinical narratives and classify retinal diseases. This vision-language model significantly outperforms existing methods in both summary generation and diagnostic accuracy.
Area of Science:
- Ophthalmology
- Artificial Intelligence
- Medical Imaging
Background:
- Interpreting Optical Coherence Tomography (OCT) B-scans for retinal diseases requires AI that combines visual data with medical knowledge.
- Existing AI models struggle to accurately translate OCT imaging features into clinical narratives.
Purpose of the Study:
- To introduce LO-VLM, a novel, compact vision-language model (VLM) designed for OCT B-scan interpretation.
- To enhance free-form summary generation and multiclass disease classification of retinal conditions.
Main Methods:
- Curated a multimodal dataset of 40,000 OCT B-scans with expert-validated summaries for six conditions.
- Developed LO-VLM, a 247M parameter VLM incorporating anatomical guidance in its encoder and decoder.
- Benchmarked LO-VLM against RetinaVLM, LLaVA-Med, and a ViT model.
Main Results:
- LO-VLM narratives received significantly higher scores (8.5/10) from retina specialists compared to RetinaVLM (5.5/10).
- Achieved superior quantitative metrics: 0.803 SBERT similarity and 0.715 BERTScore F1.
- Reached 96% accuracy in disease classification, outperforming ViT by 13% and medical VLMs by over 62%.
Conclusions:
- LO-VLM offers a new paradigm for efficient and interpretable AI in OCT analysis.
- The model demonstrates superior performance in both generating clinical narratives and classifying retinal diseases.
- LO-VLM reconciles computational efficiency with high accuracy for OCT interpretation.

