arXiv subjects

Mingguang He

Publications and source records attributed to Mingguang He.

At least 19 recordsLinked to original sources

arXiv2026

Operational digital twin clinics enable task-based evaluation of embodied AI

Embodied artificial intelligence (AI) must be tested in the clinical environments where it will operate, but building realistic, robot-testable settings is costly and difficult to scale. Here we show that routine clinic images can be transformed into operational digital twins for task-based evaluation of embodied AI. Using 39 ophthalmic clinic scenes, we converted single photographs into editable, simulator-ready environments and assessed reconstruction quality, room-scale geometry, mesh grounding, multi-robot feasibility, perturbation sensitivity and closed-loop policy performance. The reconstructed scenes preserved workspace structure, while local editing enabled controlled device reconfiguration. Device meshes, collision proxies and semantic anchors converted visual reconstructions into contact-aware simulation scenes. Across three robot embodiments, shared task targets showed different patterns of reachability and contact feasibility. Small device translations and rotations produced task-specific changes in contact margins that were not captured by visual similarity alone. Digital-twin trajectories also supported local policy learning and closed-loop evaluation. These findings establish operational validity as a key principle for clinical digital twins and provide an intermediate layer between offline development and physical deployment of embodied AI in healthcare.

cs.RO↗

arXiv2026

EyeWorld: A Generative World Model of Ocular State and Dynamics

Ophthalmic decision-making depends on subtle lesion-scale cues interpreted across multimodal imaging and over time, yet most medical foundation models remain static and degrade under modality and acquisition shifts. Here we introduce EyeWorld, a generative world model that conceptualizes the eye as a partially observed dynamical system grounded in clinical imaging. EyeWorld learns an observation-stable latent ocular state shared across modalities, unifying fine-grained parsing, structure-preserving cross-modality translation and quality-robust enhancement within a single framework. Longitudinal supervision further enables time-conditioned state transitions, supporting forecasting of clinically meaningful progression while preserving stable anatomy. By moving from static representation learning to explicit dynamical modeling, EyeWorld provides a unified approach to robust multimodal interpretation and prognosis-oriented simulation in medicine.

cs.CV↗

arXiv2026

Empowering Locally Deployable Medical Agent via State Enhanced Logical Skills for FHIR-based Clinical Tasks

While Large Language Models demonstrate immense potential as proactive Medical Agents, their real-world deployment is severely bottlenecked by data scarcity under privacy constraints. To overcome this, we propose State-Enhanced Logical-Skill Memory (SELSM), a training-free framework that distills simulated clinical trajectories into entity-agnostic operational rules within an abstract skill space. During inference, a Query-Anchored Two-Stage Retrieval mechanism dynamically fetches these entity-agnostic logical priors to guide the agent's step-by-step reasoning, effectively resolving the state polysemy problem. Evaluated on MedAgentBench -- the only authoritative high-fidelity virtual EHR sandbox benchmarked with real clinical data -- SELSM substantially elevates the zero-shot capabilities of locally deployable foundation models (30B--32B parameters). Notably, on the Qwen3-30B-A3B backbone, our framework completely eliminates task chain breakdowns to achieve a 100\% completion rate, boosting the overall success rate by an absolute 22.67\% and significantly outperforming existing memory-augmented baselines. This study demonstrates that equipping models with a dynamically updatable, state-enhanced cognitive scaffold is a privacy-preserving and computationally efficient pathway for local adaptation of AI agents to clinical information systems. While currently validated on FHIR-based EHR interactions as an initial step, the entity-agnostic design of SELSM provides a principled foundation toward broader clinical deployment.

cs.AI↗

arXiv2025

EyeAgent: An Agentic AI System for Multimodal Clinical Decision Support in Ophthalmology

Artificial intelligence has shown promise in medical imaging, yet most existing systems lack flexibility, interpretability, and adaptability - challenges especially pronounced in ophthalmology, where diverse imaging modalities are essential. We present EyeAgent, the first agentic AI framework for comprehensive and interpretable clinical decision support in ophthalmology. Using a large language model (DeepSeek-V3) as its central reasoning engine, EyeAgent interprets user queries and dynamically orchestrates 53 validated ophthalmic tools across 23 imaging modalities for diverse tasks including classification, segmentation, detection, image/report generation, and quantitative analysis. Stepwise ablation analysis demonstrated a progressive improvement in diagnostic accuracy, rising from a baseline of 69.71% (using only 5 general tools) to 80.79% when the full suite of 53 specialized tools was integrated. In an expert rating study on 200 real-world clinical cases, EyeAgent achieved 93.7% tool selection accuracy and received expert ratings of more than 88% across accuracy, completeness, safety, reasoning, and interpretability. In human-AI collaboration, EyeAgent matched or exceeded the performance of senior ophthalmologists and, when used as an assistant, improved overall diagnostic accuracy by 18.51% and report quality scores by 19%, with the greatest benefit observed among junior ophthalmologists. These findings establish EyeAgent as a scalable and trustworthy AI framework for ophthalmology and provide a blueprint for modular, multimodal, and clinically aligned next-generation AI systems.

cs.HC↗

arXiv2025

APTOS-2024 challenge report: Generation of synthetic 3D OCT images from fundus photographs

Optical Coherence Tomography (OCT) provides high-resolution, 3D, and non-invasive visualization of retinal layers in vivo, serving as a critical tool for lesion localization and disease diagnosis. However, its widespread adoption is limited by equipment costs and the need for specialized operators. In comparison, 2D color fundus photography offers faster acquisition and greater accessibility with less dependence on expensive devices. Although generative artificial intelligence has demonstrated promising results in medical image synthesis, translating 2D fundus images into 3D OCT images presents unique challenges due to inherent differences in data dimensionality and biological information between modalities. To advance generative models in the fundus-to-3D-OCT setting, the Asia Pacific Tele-Ophthalmology Society (APTOS-2024) organized a challenge titled Artificial Intelligence-based OCT Generation from Fundus Images. This paper details the challenge framework (referred to as APTOS-2024 Challenge), including: the benchmark dataset, evaluation methodology featuring two fidelity metrics-image-based distance (pixel-level OCT B-scan similarity) and video-based distance (semantic-level volumetric consistency), and analysis of top-performing solutions. The challenge attracted 342 participating teams, with 42 preliminary submissions and 9 finalists. Leading methodologies incorporated innovations in hybrid data preprocessing or augmentation (cross-modality collaborative paradigms), pre-training on external ophthalmic imaging datasets, integration of vision foundation models, and model architecture improvement. The APTOS-2024 Challenge is the first benchmark demonstrating the feasibility of fundus-to-3D-OCT synthesis as a potential solution for improving ophthalmic care accessibility in under-resourced healthcare settings, while helping to expedite medical research and clinical applications.

cs.CV↗

arXiv2025

ChatMyopia: An AI Agent for Pre-consultation Education in Primary Eye Care Settings

Large language models (LLMs) show promise for tailored healthcare communication but face challenges in interpretability and multi-task integration particularly for domain-specific needs like myopia, and their real-world effectiveness as patient education tools has yet to be demonstrated. Here, we introduce ChatMyopia, an LLM-based AI agent designed to address text and image-based inquiries related to myopia. To achieve this, ChatMyopia integrates an image classification tool and a retrieval-augmented knowledge base built from literature, expert consensus, and clinical guidelines. Myopic maculopathy grading task, single question examination and human evaluations validated its ability to deliver personalized, accurate, and safe responses to myopia-related inquiries with high scalability and interpretability. In a randomized controlled trial (n=70, NCT06607822), ChatMyopia significantly improved patient satisfaction compared to traditional leaflets, enhancing patient education in accuracy, empathy, disease awareness, and patient-eyecare practitioner communication. These findings highlight ChatMyopia's potential as a valuable supplement to enhance patient education and improve satisfaction with medical services in primary eye care settings.

cs.HC↗

arXiv2025

Benchmarking Large Multimodal Models for Ophthalmic Visual Question Answering with OphthalWeChat

Purpose: To develop a bilingual multimodal visual question answering (VQA) benchmark for evaluating VLMs in ophthalmology. Methods: Ophthalmic image posts and associated captions published between January 1, 2016, and December 31, 2024, were collected from WeChat Official Accounts. Based on these captions, bilingual question-answer (QA) pairs in Chinese and English were generated using GPT-4o-mini. QA pairs were categorized into six subsets by question type and language: binary (Binary_CN, Binary_EN), single-choice (Single-choice_CN, Single-choice_EN), and open-ended (Open-ended_CN, Open-ended_EN). The benchmark was used to evaluate the performance of three VLMs: GPT-4o, Gemini 2.0 Flash, and Qwen2.5-VL-72B-Instruct. Results: The final OphthalWeChat dataset included 3,469 images and 30,120 QA pairs across 9 ophthalmic subspecialties, 548 conditions, 29 imaging modalities, and 68 modality combinations. Gemini 2.0 Flash achieved the highest overall accuracy (0.548), outperforming GPT-4o (0.522, P < 0.001) and Qwen2.5-VL-72B-Instruct (0.514, P < 0.001). It also led in both Chinese (0.546) and English subsets (0.550). Subset-specific performance showed Gemini 2.0 Flash excelled in Binary_CN (0.687), Single-choice_CN (0.666), and Single-choice_EN (0.646), while GPT-4o ranked highest in Binary_EN (0.717), Open-ended_CN (BLEU-1: 0.301; BERTScore: 0.382), and Open-ended_EN (BLEU-1: 0.183; BERTScore: 0.240). Conclusions: This study presents the first bilingual VQA benchmark for ophthalmology, distinguished by its real-world context and inclusion of multiple examinations per patient. The dataset reflects authentic clinical decision-making scenarios and enables quantitative evaluation of VLMs, supporting the development of accurate, specialized, and trustworthy AI systems for eye care.

cs.CV↗

arXiv2025

Predicting Diabetic Macular Edema Treatment Responses Using OCT: Dataset and Methods of APTOS Competition

Diabetic macular edema (DME) significantly contributes to visual impairment in diabetic patients. Treatment responses to intravitreal therapies vary, highlighting the need for patient stratification to predict therapeutic benefits and enable personalized strategies. To our knowledge, this study is the first to explore pre-treatment stratification for predicting DME treatment responses. To advance this research, we organized the 2nd Asia-Pacific Tele-Ophthalmology Society (APTOS) Big Data Competition in 2021. The competition focused on improving predictive accuracy for anti-VEGF therapy responses using ophthalmic OCT images. We provided a dataset containing tens of thousands of OCT images from 2,000 patients with labels across four sub-tasks. This paper details the competition's structure, dataset, leading methods, and evaluation metrics. The competition attracted strong scientific community participation, with 170 teams initially registering and 41 reaching the final round. The top-performing team achieved an AUC of 80.06%, highlighting the potential of AI in personalized DME treatment and clinical decision-making.

eess.IV↗

arXiv2025

AI-powered virtual eye: perspective, challenges and opportunities

We envision the "virtual eye" as a next-generation, AI-powered platform that uses interconnected foundation models to simulate the eye's intricate structure and biological function across all scales. Advances in AI, imaging, and multiomics provide a fertile ground for constructing a universal, high-fidelity digital replica of the human eye. This perspective traces the evolution from early mechanistic and rule-based models to contemporary AI-driven approaches, integrating in a unified model with multimodal, multiscale, dynamic predictive capabilities and embedded feedback mechanisms. We propose a development roadmap emphasizing the roles of large-scale multimodal datasets, generative AI, foundation models, agent-based architectures, and interactive interfaces. Despite challenges in interpretability, ethics, data processing and evaluation, the virtual eye holds the potential to revolutionize personalized ophthalmic care and accelerate research into ocular health and disease.

q-bio.TO↗

arXiv2025

What is the role of human decisions in a world of artificial intelligence: an economic evaluation of human-AI collaboration in diabetic retinopathy screening

As Artificial intelligence (AI) has been increasingly integrated into the medical field, the role of humans may become vague. While numerous studies highlight AI's potential, how humans and AI collaborate to maximize the combined clinical benefits remains unexplored. In this work, we analyze 270 screening scenarios from a health-economic perspective in a national diabetic retinopathy screening program, involving eight human-AI collaborative strategies and traditional manual screening. We find that annual copilot human-AI screening in the 20-79 age group, with referral decisions made when both humans and AI agree, is the most cost-effective strategy for human-AI collaboration. The 'copilot' strategy brings health benefits equivalent to USD 4.64 million per 100,000 population compared to manual screening. These findings demonstrate that even in settings where AI is highly mature and efficient, human involvement remains essential to ensuring both health and economic benefits. Our findings highlight the need to optimize human-AI collaboration strategies for AI implementation into healthcare systems.

cs.HC↗

arXiv2025

Interpretable Few-Shot Retinal Disease Diagnosis with Concept-Guided Prompting of Vision-Language Models

Recent advancements in deep learning have shown significant potential for classifying retinal diseases using color fundus images. However, existing works predominantly rely exclusively on image data, lack interpretability in their diagnostic decisions, and treat medical professionals primarily as annotators for ground truth labeling. To fill this gap, we implement two key strategies: extracting interpretable concepts of retinal diseases using the knowledge base of GPT models and incorporating these concepts as a language component in prompt-learning to train vision-language (VL) models with both fundus images and their associated concepts. Our method not only improves retinal disease classification but also enriches few-shot and zero-shot detection (novel disease detection), while offering the added benefit of concept-based model interpretability. Our extensive evaluation across two diverse retinal fundus image datasets illustrates substantial performance gains in VL-model based few-shot methodologies through our concept integration approach, demonstrating an average improvement of approximately 5.8\% and 2.7\% mean average precision for 16-shot learning and zero-shot (novel class) detection respectively. Our method marks a pivotal step towards interpretable and efficient retinal disease recognition for real-world clinical applications.

eess.IV↗

arXiv2025

DeepSeek-R1 Outperforms Gemini 2.0 Pro, OpenAI o1, and o3-mini in Bilingual Complex Ophthalmology Reasoning

Purpose: To evaluate the accuracy and reasoning ability of DeepSeek-R1 and three other recently released large language models (LLMs) in bilingual complex ophthalmology cases. Methods: A total of 130 multiple-choice questions (MCQs) related to diagnosis (n = 39) and management (n = 91) were collected from the Chinese ophthalmology senior professional title examination and categorized into six topics. These MCQs were translated into English using DeepSeek-R1. The responses of DeepSeek-R1, Gemini 2.0 Pro, OpenAI o1 and o3-mini were generated under default configurations between February 15 and February 20, 2025. Accuracy was calculated as the proportion of correctly answered questions, with omissions and extra answers considered incorrect. Reasoning ability was evaluated through analyzing reasoning logic and the causes of reasoning error. Results: DeepSeek-R1 demonstrated the highest overall accuracy, achieving 0.862 in Chinese MCQs and 0.808 in English MCQs. Gemini 2.0 Pro, OpenAI o1, and OpenAI o3-mini attained accuracies of 0.715, 0.685, and 0.692 in Chinese MCQs (all P<0.001 compared with DeepSeek-R1), and 0.746 (P=0.115), 0.723 (P=0.027), and 0.577 (P<0.001) in English MCQs, respectively. DeepSeek-R1 achieved the highest accuracy across five topics in both Chinese and English MCQs. It also excelled in management questions conducted in Chinese (all P<0.05). Reasoning ability analysis showed that the four LLMs shared similar reasoning logic. Ignoring key positive history, ignoring key positive signs, misinterpretation medical data, and too aggressive were the most common causes of reasoning errors. Conclusion: DeepSeek-R1 demonstrated superior performance in bilingual complex ophthalmology reasoning tasks than three other state-of-the-art LLMs. While its clinical applicability remains challenging, it shows promise for supporting diagnosis and clinical decision-making.

cs.CL↗

arXiv2025

Fundus2Globe: Generative AI-Driven 3D Digital Twins for Personalized Myopia Management

Myopia, projected to affect 50% population globally by 2050, is a leading cause of vision loss. Eyes with pathological myopia exhibit distinctive shape distributions, which are closely linked to the progression of vision-threatening complications. Recent understanding of eye-shape-based biomarkers requires magnetic resonance imaging (MRI), however, it is costly and unrealistic in routine ophthalmology clinics. We present Fundus2Globe, the first AI framework that synthesizes patient-specific 3D eye globes from ubiquitous 2D color fundus photographs (CFPs) and routine metadata (axial length, spherical equivalent), bypassing MRI dependency. By integrating a 3D morphable eye model (encoding biomechanical shape priors) with a latent diffusion model, our approach achieves submillimeter accuracy in reconstructing posterior ocular anatomy efficiently. Fundus2Globe uniquely quantifies how vision-threatening lesions (e.g., staphylomas) in CFPs correlate with MRI-validated 3D shape abnormalities, enabling clinicians to simulate posterior segment changes in response to refractive shifts. External validation demonstrates its robust generation performance, ensuring fairness across underrepresented groups. By transforming 2D fundus imaging into 3D digital replicas of ocular structures, Fundus2Globe is a gateway for precision ophthalmology, laying the foundation for AI-driven, personalized myopia management.

eess.IV↗

arXiv2024

FFA Sora, video generation as fundus fluorescein angiography simulator

Fundus fluorescein angiography (FFA) is critical for diagnosing retinal vascular diseases, but beginners often struggle with image interpretation. This study develops FFA Sora, a text-to-video model that converts FFA reports into dynamic videos via a Wavelet-Flow Variational Autoencoder (WF-VAE) and a diffusion transformer (DiT). Trained on an anonymized dataset, FFA Sora accurately simulates disease features from the input text, as confirmed by objective metrics: Frechet Video Distance (FVD) = 329.78, Learned Perceptual Image Patch Similarity (LPIPS) = 0.48, and Visual-question-answering Score (VQAScore) = 0.61. Specific evaluations showed acceptable alignment between the generated videos and textual prompts, with BERTScore of 0.35. Additionally, the model demonstrated strong privacy-preserving performance in retrieval evaluations, achieving an average Recall@K of 0.073. Human assessments indicated satisfactory visual quality, with an average score of 1.570(scale: 1 = best, 5 = worst). This model addresses privacy concerns associated with sharing large-scale FFA data and enhances medical education.

cs.CV↗

arXiv2024

EyeDiff: text-to-image diffusion model improves rare eye disease diagnosis

The rising prevalence of vision-threatening retinal diseases poses a significant burden on the global healthcare systems. Deep learning (DL) offers a promising solution for automatic disease screening but demands substantial data. Collecting and labeling large volumes of ophthalmic images across various modalities encounters several real-world challenges, especially for rare diseases. Here, we introduce EyeDiff, a text-to-image model designed to generate multimodal ophthalmic images from natural language prompts and evaluate its applicability in diagnosing common and rare diseases. EyeDiff is trained on eight large-scale datasets using the advanced latent diffusion model, covering 14 ophthalmic image modalities and over 80 ocular diseases, and is adapted to ten multi-country external datasets. The generated images accurately capture essential lesional characteristics, achieving high alignment with text prompts as evaluated by objective metrics and human experts. Furthermore, integrating generated images significantly enhances the accuracy of detecting minority classes and rare eye diseases, surpassing traditional oversampling methods in addressing data imbalance. EyeDiff effectively tackles the issue of data imbalance and insufficiency typically encountered in rare diseases and addresses the challenges of collecting large-scale annotated images, offering a transformative solution to enhance the development of expert-level diseases diagnosis models in ophthalmic field.

eess.IV↗

arXiv2024

Visual Question Answering in Ophthalmology: A Progressive and Practical Perspective

Accurate diagnosis of ophthalmic diseases relies heavily on the interpretation of multimodal ophthalmic images, a process often time-consuming and expertise-dependent. Visual Question Answering (VQA) presents a potential interdisciplinary solution by merging computer vision and natural language processing to comprehend and respond to queries about medical images. This review article explores the recent advancements and future prospects of VQA in ophthalmology from both theoretical and practical perspectives, aiming to provide eye care professionals with a deeper understanding and tools for leveraging the underlying models. Additionally, we discuss the promising trend of large language models (LLM) in enhancing various components of the VQA framework to adapt to multimodal ophthalmic tasks. Despite the promising outlook, ophthalmic VQA still faces several challenges, including the scarcity of annotated multimodal image datasets, the necessity of comprehensive and unified evaluation methods, and the obstacles to achieving effective real-world applications. This article highlights these challenges and clarifies future directions for advancing ophthalmic VQA with LLMs. The development of LLM-based ophthalmic VQA systems calls for collaborative efforts between medical professionals and AI experts to overcome existing obstacles and advance the diagnosis and care of eye diseases.

eess.IV↗

arXiv2024

Fundus to Fluorescein Angiography Video Generation as a Retinal Generative Foundation Model

Fundus fluorescein angiography (FFA) is crucial for diagnosing and monitoring retinal vascular issues but is limited by its invasive nature and restricted accessibility compared to color fundus (CF) imaging. Existing methods that convert CF images to FFA are confined to static image generation, missing the dynamic lesional changes. We introduce Fundus2Video, an autoregressive generative adversarial network (GAN) model that generates dynamic FFA videos from single CF images. Fundus2Video excels in video generation, achieving an FVD of 1497.12 and a PSNR of 11.77. Clinical experts have validated the fidelity of the generated videos. Additionally, the model's generator demonstrates remarkable downstream transferability across ten external public datasets, including blood vessel segmentation, retinal disease diagnosis, systemic disease prediction, and multimodal retrieval, showcasing impressive zero-shot and few-shot capabilities. These findings position Fundus2Video as a powerful, non-invasive alternative to FFA exams and a versatile retinal generative foundation model that captures both static and temporal retinal features, enabling the representation of complex inter-modality relationships.

cs.CV↗

arXiv2024

EyeCLIP: A visual-language foundation model for multi-modal ophthalmic image analysis

Early detection of eye diseases like glaucoma, macular degeneration, and diabetic retinopathy is crucial for preventing vision loss. While artificial intelligence (AI) foundation models hold significant promise for addressing these challenges, existing ophthalmic foundation models primarily focus on a single modality, whereas diagnosing eye diseases requires multiple modalities. A critical yet often overlooked aspect is harnessing the multi-view information across various modalities for the same patient. Additionally, due to the long-tail nature of ophthalmic diseases, standard fully supervised or unsupervised learning approaches often struggle. Therefore, it is essential to integrate clinical text to capture a broader spectrum of diseases. We propose EyeCLIP, a visual-language foundation model developed using over 2.77 million multi-modal ophthalmology images with partial text data. To fully leverage the large multi-modal unlabeled and labeled data, we introduced a pretraining strategy that combines self-supervised reconstructions, multi-modal image contrastive learning, and image-text contrastive learning to learn a shared representation of multiple modalities. Through evaluation using 14 benchmark datasets, EyeCLIP can be transferred to a wide range of downstream tasks involving ocular and systemic diseases, achieving state-of-the-art performance in disease classification, visual question answering, and cross-modal retrieval. EyeCLIP represents a significant advancement over previous methods, especially showcasing few-shot, even zero-shot capabilities in real-world long-tail scenarios.

cs.CV↗