Robust Collaborative Learning of Patch-level and Image-level Annotations for Diabetic Retinopathy Grading from Fundus Image

Currently, diabetic retinopathy (DR) grading from fundus images has attracted incremental interests in both academic and industrial communities. Most convolutional neural networks (CNNs) based algorithms treat DR grading as a classification task via image-level annotations. However, they have not fully explored the valuable information from the DR-related lesions. In this paper, we present a robust framework, which can collaboratively utilize both patch-level lesion and image-level grade annotations, for DR severity grading. By end-to-end optimizing the entire framework, the fine-grained lesion and image-level grade information can be bidirectionally exchanged to exploit more discriminative features for DR grading. Compared with the recent state-of-the-art algorithms and three over 9-years clinical experienced ophthalmologists, the proposed algorithm shows favorable performance. Testing on the datasets from totally different scenarios and distributions (such as label and camera), our algorithm is proved robust in facing image quality and distribution problems that commonly exist in real-world practice. Extensive ablation studies dissect the proposed framework and indicate the effectiveness and necessity of each motivation. The code and some valuable annotations are now publicly available.