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Uncertainty-Aware Training for Ophthalmic Segmentation Using MedSAM
Christopher William Clark1, Scott Kinder1, Giacomo Nebbia1
1University of Colorado School of Medicine, Aurora CO, USA.
Translational Vision Science & Technology
|February 17, 2026
Summary
Uncertainty-Aware Training (UAT) improves deep learning (DL) models by using uncertainty maps to guide learning. This method enhances ophthalmic segmentation accuracy by focusing on ambiguous areas during training.
Area of Science:
- Ophthalmic imaging analysis
- Medical deep learning
- Uncertainty quantification
Background:
- Deep learning (DL) models require enhanced interpretability and learning guidance.
- Uncertainty quantification (UQ) is a key area for improving DL model reliability.
- Ophthalmic segmentation tasks benefit from precise pixel-level classification.
Purpose of the Study:
- Introduce Uncertainty-Aware Training (UAT) to augment DL loss functions with uncertainty maps.
- Enhance DL model performance and interpretability by focusing on areas of high uncertainty.
- Improve accuracy in ophthalmic segmentation tasks like geographic atrophy (GA), optic cup (OC), and foveal avascular zone (FAZ).
Main Methods:
- Applied UAT to three ophthalmic segmentation tasks: GA, OC, and FAZ.
- Weighted binary cross-entropy loss function using uncertainty maps to focus on ambiguous regions.
- Experimented with entropy-based UQ and conformal prediction techniques.
- Evaluated UAT on a fine-tuned state-of-the-art foundational model.
Main Results:
- Entropy-weighted maps at loss calculation consistently improved performance across all datasets.
- Conformal prediction (Least Ambiguous Set-Valued Classifier) enhanced GA and OC segmentation.
- UAT integration was feasible without significant modifications to training structures.
Conclusions:
- UAT effectively enhances DL model performance and interpretability by incorporating uncertainty alongside error.
- The method improves segmentation accuracy in ophthalmic applications.
- UAT's lightweight integration facilitates practical adoption and improved model performance.

