Multi-style spatial attention module for cortical cataract classification in AS-OCT image with supervised contrastive learning

Background and Objective: Precise cortical cataract (CC) classification plays a significant role in early cataract intervention and surgery. Anterior segment optical coherence tomography (AS-OCT) images have shown excellent potential in cataract diagnosis. However, due to the complex opacity distributions of CC, automatic AS-OCT-based CC classification has been rarely studied. In this paper, we aim to explore the opacity distribution characteristics of CC as clinical priori to enhance the representational capability of deep convolutional neural networks (CNNs) in CC classification tasks. Methods: We propose a novel architectural unit, Multi-style Spatial Attention module (MSSA), which recalibrates intermediate feature maps by exploiting diverse clinical contexts. MSSA first extracts the clinical style context features with Group-wise Style Pooling (GSP), then refines the clinical style context features with Local Transform (LT), and finally executes group-wise feature map recalibration via Style Feature Recalibration (SFR). MSSA can be easily integrated into modern CNNs with negligible overhead. Results: The extensive experiments on a CASIA2 AS-OCT dataset and two public ophthalmic datasets demonstrate the superiority of MSSA over state-of-the-art attention methods. The visualization analysis and ablation study are conducted to improve the explainability of MSSA in the decision-making process. Conclusions: Our proposed MSSANet utilized the opacity distribution characteristics of CC to enhance the representational power and explainability of deep convolutional neural network (CNN) and improve the CC classification performance. Our proposed method has the potential in the early clinical CC diagnosis.