REVEAL++: Differentiable Phenotypic Grouping for Vision-Language Retinal Modeling of Alzheimer's Disease Risk
The paper proposes REVEAL++, a continuous formulation of phenotypic grouping in contrastive learning for vision-language alignment using retinal images and clinical risk narratives to predict Alzheimer's disease risk. It replaces hard group assignments with differentiable weights, enabling graded supervision and end-to-end learning. Evaluated on UK Biobank, it outperforms discrete methods.
[2606.19522] REVEAL++: Differentiable Phenotypic Grouping for Vision-Language Retinal Modeling of Alzheimer's Disease Risk
[Submitted on 17 Jun 2026]
Title:REVEAL++: Differentiable Phenotypic Grouping for Vision-Language Retinal Modeling of Alzheimer's Disease Risk
View a PDF of the paper titled REVEAL++: Differentiable Phenotypic Grouping for Vision-Language Retinal Modeling of Alzheimer's Disease Risk, by Ethan Elio Meidinger and 3 other authors
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Abstract:The retina offers a noninvasive window into neurodegenerative disease, capturing subtle structural patterns associated with a risk of future cognitive decline. Vision-language alignment frameworks such as REVEAL have shown that pairing retinal fundus images with structured clinical risk narratives improves early prediction of Alzheimer's disease (AD). A key design choice in these approaches is the use of phenotypic grouping, where individuals with similar risk profiles are treated as multi-positive pairs during contrastive learning. However, existing methods operationalize phenotypic similarity as a discrete construct, relying on hard group assignments that impose rigid supervision and decouple group formation from representation learning. We propose a continuous formulation of phenotypic structure within contrastive learning. Rather than assigning samples to fixed clusters, we model inter-subject similarity as a differentiable weighting function derived from intra-modality embedding similarities in both retinal images and risk profiles. These weights define soft multi-positive relationships through a continuous aggregation operator, enabling graded supervision that reflects the spectrum nature of disease risk. We further introduce a soft-target contrastive objective that jointly learns cross-modal alignment and phenotypic structure in an end-to-end manner. Evaluated on UK Biobank retinal imaging data for incident AD prediction, the proposed framework consistently outperforms discrete group-based contrastive learning and standard vision-language baselines. By treating phenotypic similarity as a learnable, continuous signal rather than a fixed grouping rule, our approach provides a principled and robust foundation for population-scale neurodegenerative risk modeling from multi-modal retinal and clinical data.
Comments: Accepted for publication at MICCAI 2026
Subjects:
Artificial Intelligence (cs.AI)
Cite as: arXiv:2606.19522 [cs.AI]
(or arXiv:2606.19522v1 [cs.AI] for this version)
https://doi.org/10.48550/arXiv.2606.19522
arXiv-issued DOI via DataCite (pending registration)
Submission history
From: Ethan Meidinger [view email] [v1] Wed, 17 Jun 2026 19:09:12 UTC (1,680 KB)
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