TRIAGE: Risk-Controlled Pseudo-Label Admission for Annotation-Efficient Semi-Supervised Retinal OCT Classification

• URL: http://arxiv.org/abs/2608.14321v1
• Date: Fri, 14 Aug 2026 14:06:48 GMT
• Title: TRIAGE: Risk-Controlled Pseudo-Label Admission for Annotation-Efficient Semi-Supervised Retinal OCT Classification
• Abstract summary: This paper proposes TRIAGE, a risk-controlled semi-supervised framework for OCT scans classification.<n>On the dataset from Noor Eye Hospital (16,822 B-scans, 161 patients, and 554 volumes), TRIAGE demonstrates 89.66% scan-level accuracy, 0.8805 macro-F1, 0.9641 macro-AUC, and an 8.34% under-grading rate.
• Score: 0.6213771671016098
• License: http://creativecommons.org/licenses/by-nc-nd/4.0/
• Abstract: The advanced retinal disease diagnosing imaging modality, optical coherence tomography (OCT), encounters a lack of automation because of the high expenses for annotations performed by specialists. The use of SSL solves the problem of insufficient annotations using unlabeled B-scans; however, most of the current techniques for generating pseudo-labels are based on prediction confidence without considering the asymmetry between different types of errors. This paper proposes TRIAGE, a risk-controlled semi-supervised framework for OCT scans classification, which uses the concept of a patient-level conformal risk controller with an asymmetric cost matrix. TRIAGE unites three crucial modules: a hierarchical classifier that is capable of working with partially abnormal supervision of the disease subtypes, a patient-grouped conformal risk controller with primal-dual coverage control, and a context-aware Transformer teacher for cross-slice verification. On the dataset from Noor Eye Hospital (16,822 B-scans, 161 patients, and 554 volumes) with a test set of unseen patients, TRIAGE demonstrates 89.66% scan-level accuracy, 0.8805 macro-F1, 0.9641 macro-AUC, and an 8.34% under-grading rate when using only 20% of the labeled data. With only 5% of the labeled data, TRIAGE keeps 76.88% accuracy and a 0.1656 under-grading rate. Compared with the other six state-of-the-art semi-supervised methods, TRIAGE significantly outperforms them with ablation study demonstrating the contribution of each module in the overall framework performance (by 42.7% in terms of under-grading rate comparing to fixed threshold methods). TRIAGE demonstrates 98.00% accuracy for 3-class classification with 1% labeled data and 95.94% accuracy for 8-class classification with 10% labeled data on the OCT-C8 dataset.

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