Optical coherence tomography (OCT) is a widely used non-invasive imaging modality for ophthalmic diagnosis. However, the inherent speckle noise becomes the leading cause of OCT image quality, and efficient speckle removal algorithms can improve image readability and benefit automated clinical analysis. As an ill-posed inverse problem, it is of utmost importance for speckle removal to learn suitable priors. In this work, we develop a score prior guided iterative solver (SPIS) with logarithmic space to remove speckles in OCT images. Specifically, we model the posterior distribution of raw OCT images as a data consistency term and transform the speckle removal from a nonlinear into a linear inverse problem in the logarithmic domain. Subsequently, the learned prior distribution through the score function from the diffusion model is utilized as a constraint for the data consistency term into the linear inverse optimization, resulting in an iterative speckle removal procedure that alternates between the score prior predictor and the subsequent non-expansive data consistency corrector. Experimental results on the private and public OCT datasets demonstrate that the proposed SPIS has an excellent performance in speckle removal and out-of-distribution (OOD) generalization. Further downstream automatic analysis on the OCT images verifies that the proposed SPIS can benefit clinical applications. The data and code are available at https://github.com/ lisanqian1212/SPIS.
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