ADAM-Net: Anatomy-Guided Attentive Unsupervised Domain Adaptation for Joint MG Segmentation and MGD Grading.

Meibomian gland dysfunction (MGD) is a leading cause of dry eye disease, assessable through gland atrophy degree. While deep learning (DL) has advanced meibomian gland (MG) segmentation and MGD classification, existing methods treat these tasks independently and suffer from domain shift across multi-center imaging devices. We propose ADAM-Net, an attention-guided unsupervised domain adaptation multi-task framework that jointly models MG segmentation and MGD classification. Our model introduces structure-aware multi-task learning and anatomy-guided attention to enhance feature sharing, suppress background noise, and improve glandular region perception. For the cross-domain tasks MGD-1K→{K5M, CR-2, LV II}, this study systematically evaluates the overall performance of ADAM-Net from multiple perspectives. The experimental results show that ADAM-Net achieves classification accuracies of 77.93%, 74.86%, and 81.77% on the target domains, significantly outperforming current mainstream unsupervised domain adaptation (UDA) methods. The F1-score and the Matthews correlation coefficient (MCC-score) indicate that the model maintains robust discriminative capability even under class-imbalanced scenarios. t-SNE visualizations further validate its cross-domain feature alignment capability. These demonstrate that ADAM-Net exhibits strong robustness and interpretability in multi-center scenarios and provide an effective solution for automated MGD assessment.