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Deep learning strategies for estimating retinal thickness from fundus images: a comparative study with multi-device

Noriyoshi Takahashi¹, Nikhil Gadiraju¹, Judy E Kim¹

¹Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Scientific Reports

|May 16, 2026

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This study developed a deep learning model to estimate retinal thickness from color fundus photographs, eliminating the need for costly optical coherence tomography scans in diabetic retinopathy screening.

Area of Science:

Ophthalmology
Medical Imaging
Artificial Intelligence

Background:

Color fundus photographs (CFPs) are accessible for diabetic retinopathy (DR) screening.
Optical coherence tomography (OCT) offers detailed retinal structure but is less practical for large-scale screening due to cost and complexity.

Purpose of the Study:

To develop a deep learning framework using a foundation model (FM) to estimate OCT-derived total retinal thickness (TRT) maps directly from CFPs.
To evaluate different decoder training strategies for TRT estimation and assess robustness to inter-device variability.

Main Methods:

Utilized the RETFound foundation model as the backbone.
Trained and evaluated on the AI-READI dataset with paired CFPs and OCT scans from Topcon Maestro2 and Triton devices.

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Compared Individual, Combination, and Random Selection decoder training strategies for TRT estimation.

Main Results:

A significant inter-device thickness difference was observed between Maestro2 and Triton OCT devices.
Individual and Combination models showed low bias (approx. 5% relative difference) against device-specific references.
The Random Selection model demonstrated robustness to device variability by converging to an average TRT distribution.

Conclusions:

The proposed FM-based framework successfully estimates retinal thickness from CFPs, bridging the gap between CFP and OCT imaging.
This approach offers a cost-effective and practical solution for large-scale DR screening by leveraging readily available CFPs.