<![CDATA[Glaucoma is a progressive optic neuropathy and a major cause of irreversible blindness. Early detection is crucial, yet current practice depends on manual estimation of the vertical Cup-to-Disc Ratio (vCDR), which is subjective and inefficient. Automated fundus image analysis provides scalable solutions but is challenged by low optic cup contrast, dataset variability, and the need for clinically interpretable outcomes. This study aimed to develop and evaluate an automated glaucoma screening pipeline based on optic disc (OD) and optic cup (OC) segmentation, comparing a single-stage model (YOLO11-Segmentation) with a two-stage model (Mask R-CNN with ResNet50-FPN), and validating it using vCDR at a threshold of 0.7. The contributions are fourfold: establishing a benchmark comparison of YOLO11 and Mask R-CNN across three datasets (REFUGE, ORIGA, G1020); linking segmentation accuracy to vCDR-based screening; analyzing precision–recall trade-offs between the models; and providing a reproducible baseline for future studies. The pipeline employed standardized preprocessing (optic nerve head cropping, resizing to 1024×1024, conservative augmentation). YOLO11 was trained for 200 epochs, and Mask R-CNN for 75 epochs. Evaluation metrics included Dice, Intersection over Union (IoU), mean absolute error (MAE), correlation, and classification performance. Results showed that Mask R-CNN achieved higher disc Dice (0.947 in G1020, 0.938 in REFUGE) and recall (0.880 in REFUGE), while YOLO11 attained stronger vCDR correlation (r = 0.900 in ORIGA) and perfect precision (1.000 in G1020). Overall accuracy exceeded 0.92 in REFUGE and G1020. In conclusion, YOLO11 favored conservative screening with fewer false positives, while Mask R-CNN improved sensitivity. These complementary strengths highlight the importance of model selection by screening context and suggest future research on hybrid frameworks and multimodal integration]]>
