Multi-Level Feature Fusion Attention Generative Adversarial Network for Retinal Optical Coherence Tomography Image Denoising

Background: Optical coherence tomography (OCT) is limited by inherent speckle noise, degrading retinal microarchitecture visualization and pathological analysis. Existing denoising methods inadequately balance noise suppression and structural preservation, necessitating advanced solutions for clinical OCT reconstruction. Methods: We propose MFFA-GAN, a generative adversarial network integrating multilevel feature fusion and an efficient local attention (ELA) mechanism. It optimizes cross-feature interactions and channel-wise information flow. Evaluations on three public OCT datasets compared traditional methods and deep learning models using PSNR, SSIM, CNR, and ENL metrics. Results: MFFA-GAN achieved good performance (PSNR:30.107 dB, SSIM:0.727, CNR:3.927, ENL:529.161) on smaller datasets, outperforming benchmarks and further enhanced interpretability through pixel error maps. It preserved retinal layers and textures while suppressing noise. Ablation studies confirmed the synergy of multilevel features and ELA, improving PSNR by 1.8 dB and SSIM by 0.12 versus baselines. Conclusions: MFFA-GAN offers a reliable OCT denoising solution by harmonizing noise reduction and structural fidelity. Its hybrid attention mechanism enhances clinical image quality, aiding retinal analysis and diagnosis.