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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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Related Experiment Video

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A novel superpixel based Vision Transformer for improving interpretability in glaucoma screening.

Jorge Hernández1, Silvia Alayón2, José F Sigut2

  • 1Department of Computer Science and Systems Engineering, University of La Laguna, 38200, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain. jhernanv@ull.edu.es.

Scientific Reports
|March 28, 2026
PubMed
Summary

This study introduces Superpixel-based Vision Transformers (SpxViT) for glaucoma screening. SpxViT enhances model interpretability and diagnostic transparency in medical imaging while maintaining high accuracy.

Keywords:
Attention mapsExplainable AI (XAI)Glaucoma screeningInterpretabilityOphthalmologySuperpixelsVision Transformer (ViT)

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Area of Science:

  • Ophthalmology
  • Artificial Intelligence
  • Medical Image Analysis

Background:

  • Clinical adoption of deep learning in medical imaging faces interpretability challenges.
  • Explainable AI (XAI) is crucial for trust and transparency in ophthalmology, especially for glaucoma screening.

Purpose of the Study:

  • To introduce Superpixel-based Vision Transformer (SpxViT) for enhanced interpretability in glaucoma screening.
  • To evaluate SpxViT's accuracy and clinical consistency compared to traditional Vision Transformers (ViTs).

Main Methods:

  • Developed SpxViT, replacing fixed grid tokenization with superpixel-based segmentation to preserve semantic boundaries.
  • Evaluated two SpxViT variants (SpxViT_fix, SpxViT_var) on public and private glaucoma datasets.

Main Results:

  • SpxViT achieved accuracy comparable to ViT-B/16 (91.9% vs. 92.5%).
  • SpxViT generated more clinically consistent attention maps, focusing on the optic disc and cup.

Conclusions:

  • SpxViT offers a promising approach to improve interpretability in deep learning for glaucoma screening.
  • The superpixel-based method enhances diagnostic transparency without sacrificing accuracy.