Topological Continuity-Enforced Retinal Vessel Segmentation via Frequency-Aware Decomposition and Prototype Refinement

Automated and accurate segmentation of retinal vessels in fundus images provides pivotal evidence for ophthalmologists to effectively and non-invasively diagnose prevalent ocular and systemic diseases. However, existing methods often struggle to maintain the topological continuity of fine-diameter capillaries, leading to severe vascular discontinuity and fragmented segmentation results in challenging scenarios such as complex, irregular microvascular branches, pathological lesions, and high-noise conditions. To address these limitations, we developed a novel symmetric dual-branch network with frequency-aware decomposition and prototype refinement (FDPR-DBNet). Specifically, the network initially utilizes the discrete wavelet transform (DWT) to decompose input retinal images into high-frequency and low-frequency components, which are then processed by a structurally symmetric dual-branch encoder. In the high-frequency branch, the parallel atrous convolution activation (PACA) module is designed to explore fine-grained contour and edge patterns related to vessel terminals and microvessels. Concurrently, within the low-frequency branch, the spatial-frequency characteristic activation (SFCA) unit is constructed by introducing the selective state-space model (S6) and Fourier transform to extract salient structural backbones. Moreover, the spatial attention residual fusion (SARF) module and cross-frequency fusion (CFF) block are designed to establish a symmetric guidance mechanism, effectively reinforcing bidirectional feature interaction and alignment across different frequency spectra to eliminate vascular fragmentation. Furthermore, by embedding global and local window self-attention into the Transformer, we formulated the cross-scale enhancement (CSE) module, comprising global semantic enhancement (GSE) and local detail enhancement (LDE), to model multi-scale contextual semantic correlations and enhance the adaptive recognition of vessel structures. Ultimately, we embedded the multi-wise prototype characteristic refinement (MPCR) component into the decoder to correct cross-scale semantic features through a dynamic calibration mechanism, while introducing a new connectivity loss to strictly enforce topological continuity. Experimental results on four publicly available retinal image datasets (DRIVE, CHASE_DB1, STARE, and IOSTAR) demonstrate that the proposed model achieves competitive performance and effectively preserves vascular integrity even in the presence of fundus lesions and noise.