Disentangling and Fusing Neurostructural and Vascular Ageing for Retinal Age Prediction

Junwen Zheng; Li Rong Wang; Anthony Zihan Lin; Xinran Xu; Wei Kiong Ngo; Kelvin Zhenghao Li; Tock Han Lim; Xiuyi Fan

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arXiv · 2609.38264

Disentangling and Fusing Neurostructural and Vascular Ageing for Retinal Age Prediction

Junwen Zheng·Li Rong Wang·Anthony Zihan Lin·Xinran Xu·Wei Kiong Ngo·Kelvin Zhenghao Li·Tock Han Lim·Xiuyi Fan

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Abstract

Estimating biological age is an important task in ageing research, as it quantifies individual ageing trajectories beyond chronological age. Retinal age estimation has become a well-established direction in this area because retinal imaging provides a non-invasive window into neural and microvascular ageing. Existing studies, however, have predominantly focused on fundus photographs and usually model retinal ageing as a single generic process. Although biological ageing is heterogeneous and different organs or tissues may age at different rates, little research has explicitly distinguished neurostructural and vascular ageing in retinal age prediction. This work fills this gap by studying neurostructural ageing with Optical Coherence Tomography (OCT) images and vascular ageing with Optical Coherence Tomography Angiography (OCTA) images. We formulate multimodal OCT/OCTA retinal age estimation as a structural-vascular ageing decomposition problem and propose SAP-DPF, a unified dual-path prediction framework that separately estimates structural and vascular ageing, models modality-specific predictive uncertainty, and adaptively fuses the two ageing signals through an uncertainty-gated late-fusion module. Using this unified prediction framework, SAP-DPF achieves a mean absolute error of 4.07 years for the structural pathway and 7.37 years for the vascular pathway, while the proposed late-fusion algorithm further improves the overall mean absolute error to 4.02 years, representing a 12.52% improvement over the strongest single-modality baseline. This work could extend retinal age prediction beyond a single biological-age estimate, providing a framework for investigating structural and vascular contributions to heterogeneous retinal ageing.

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Junwen Zheng, Li Rong Wang, Anthony Zihan Lin, Xinran Xu, Wei Kiong Ngo, Kelvin Zhenghao Li, Tock Han Lim, Xiuyi Fan. 2026-10-20. Disentangling and Fusing Neurostructural and Vascular Ageing for Retinal Age Prediction. https://arxiv.org/abs/2609.38264

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