This study aims to improve the detection performance of age-related macular degeneration (AMD) in low-quality retinal images. Background AMD is a leading cause of vision loss among older adults globally, and accurate detection is crucial for clinical management. However, low-quality optical coherence tomography (OCT) images significantly compromise diagnostic accuracy. Objective To enhance AMD detection in low-quality images using noise-augmented data augmentation and an improved YOLO deep learning model. Methods Public datasets from UCSD and Duke University were utilized; the training dataset comprised 24,980 OCT images (high-quality and noise-augmented low-quality), while the testing dataset included 1,000 images (584 AMD, 416 normal). The model is based on the YOLOv8n framework, integrated with Squeeze-and-Excitation blocks (SEblock) and Adaptive Sparse Self-Attention (ASSA), with an additional 160×160 detection layer for detecting small lesions. Evaluation metrics included accuracy, sensitivity, specificity, and F2-score. Results The proposed model achieved an accuracy of 99.02%, sensitivity of 98.17%, specificity of 100%, and an F2-score of 98.50% on the Duke dataset. Detection rates were significantly improved compared to traditional methods, particularly in low-quality images, with a detection rate of 89.60%, markedly superior to original YOLOv8n (55.10%) and classical models like ResNet50. Conclusion The enhanced model, employing noise-augmented training data and improved attention mechanisms, demonstrates excellent AMD detection capabilities in low-quality OCT images, showing broad potential for clinical applications. ### Competing Interest Statement The authors have declared no competing interest.
