Diabetic Retinopathy Screening Using Custom-Designed Convolutional Neural Network

The prevalence of diabetic retinopathy (DR) has reached 34.6% worldwide and is a major cause of blindness among middle-aged diabetic patients. Regular DR screening using fundus photography helps detect its complications and prevent its progression to advanced levels. As manual screening is time-consuming and subjective, machine learning (ML) and deep learning (DL) have been employed to aid graders. However, the existing CNN-based methods use either pre-trained CNN models or a brute force approach to design new CNN models, which are not customized to the complexity of fundus images. To overcome this issue, we introduce an approach for custom-design of CNN models, whose architectures are adapted to the structural patterns of fundus images and better represent the DR-relevant features. It takes the leverage of k-medoid clustering, principal component analysis (PCA), and inter-class and intra-class variations to automatically determine the depth and width of a CNN model. The designed models are lightweight, adapted to the internal structures of fundus images, and encode the discriminative patterns of DR lesions. The technique is validated on a local dataset from King Saud University Medical City, Saudi Arabia, and two challenging benchmark datasets from Kaggle: EyePACS and APTOS2019. The custom-designed models outperform the famous pre-trained CNN models like ResNet152, Densnet121, and ResNeSt50 with a significant decrease in the number of parameters and compete well with the state-of-the-art CNN-based DR screening methods. The proposed approach is helpful for DR screening under diverse clinical settings and referring the patients who may need further assessment and treatment to expert ophthalmologists.