Comparative Analysis of Deep Learning Architectures for Macular Hole Segmentation in OCT Images: A Performance Evaluation of U-Net Variants.

This study presents a comprehensive comparison of U-Net variants with different backbone architectures for Macular Hole (MH) segmentation in optical coherence tomography (OCT) images. We evaluated eleven architectures, including U-Net combined with InceptionNetV4, VGG16, VGG19, ResNet152, DenseNet121, EfficientNet-B7, MobileNetV2, Xception, and Transformer. Models were assessed using the Dice coefficient and HD95 metrics on the OIMHS dataset. While HD95 proved unreliable for small regions like MH, often returning 'nan' values, the Dice coefficient provided consistent performance evaluation. InceptionNetV4 + U-Net achieved the highest Dice coefficient (0.9672), demonstrating superior segmentation accuracy. Although considered state-of-the-art, Transformer + U-Net showed poor performance in MH and intraretinal cyst (IRC) segmentation. Analysis of computational resources revealed that MobileNetV2 + U-Net offered the most efficient performance with minimal parameters, while InceptionNetV4 + U-Net balanced accuracy with moderate computational demands. Our findings suggest that CNN-based backbones, particularly InceptionNetV4, are more effective than Transformer architectures for OCT image segmentation, with InceptionNetV4 + U-Net emerging as the most promising model for clinical applications.