Improving retinal vessel assessment precision by integrating deep learning with interactive editing and graphical modeling.

We present the SEoul Retinal Vessel Assessment Library (SERVAL), a novel software platform for precise quantitative measurement of vascular structures in fundus images. SERVAL integrates deep learning-based automatic artery and vein mask initialization, subpixel vessel centerline and boundary refinement, and interactive editing tools within a user-friendly graphical interface. From the refined artery and vein delineations, it enables accurate computation of a wide range of vessel assessment metrics, facilitating better characterization of complex vascular structures. We evaluate SERVAL through: (1) comparative analyses with existing platforms, highlighting its superior precision and structural detail; (2) longitudinal image studies demonstrating measurement consistency; and (3) a usability study confirming its clinical practicality. We expect SERVAL to serve as a valuable tool in clinical research, supporting the development of novel vascular biomarkers and diagnostic metrics for retinal and systemic diseases.