Diabetic Retinopathy Detection Based on Convolutional Neural Networks with SMOTE and CLAHE Techniques Applied to Fundus Images

Diabetic retinopathy (DR) is one of the major complications in diabetic patients' eyes, potentially leading to permanent blindness if not detected timely. This study aims to evaluate the accuracy of artificial intelligence (AI) in diagnosing DR. The method employed is the Synthetic Minority Over-sampling Technique (SMOTE) algorithm, applied to identify DR and its severity stages from fundus images using the public dataset "APTOS 2019 Blindness Detection." Literature was reviewed via ScienceDirect, ResearchGate, Google Scholar, and IEEE Xplore. Classification results using Convolutional Neural Network (CNN) showed the best performance for the binary classes normal (0) and DR (1) with an accuracy of 99.55%, precision of 99.54%, recall of 99.54%, and F1-score of 99.54%. For the multiclass classification No_DR (0), Mild (1), Moderate (2), Severe (3), Proliferate_DR (4), the accuracy was 95.26%, precision 95.26%, recall 95.17%, and F1-score 95.23%. Evaluation using the confusion matrix yielded results of 99.68% for binary classification and 96.65% for multiclass. This study highlights the significant potential in enhancing the accuracy of DR diagnosis compared to traditional human analysis

Early detection of diabetes through transfer learning-based eye (vision) screening and improvement of machine learning model performance and advanced parameter setting algorithms

Diabetic Retinopathy (DR) is a serious and common complication of diabetes, caused by prolonged high blood sugar levels that damage the small retinal blood vessels. If left untreated, DR can progress to retinal vein occlusion and stimulate abnormal blood vessel growth, significantly increasing the risk of blindness. Traditional diabetes diagnosis methods often utilize convolutional neural networks (CNNs) to extract visual features from retinal images, followed by classification algorithms such as decision trees and k-nearest neighbors (KNN) for disease detection. However, these approaches face several challenges, including low accuracy and sensitivity, lengthy machine learning (ML) model training due to high data complexity and volume, and the use of limited datasets for testing and evaluation. This study investigates the application of transfer learning (TL) to enhance ML model performance in DR detection. Key improvements include dimensionality reduction, optimized learning rate adjustments, and advanced parameter tuning algorithms, aimed at increasing efficiency and diagnostic accuracy. The proposed model achieved an overall accuracy of 84% on the testing dataset, outperforming prior studies. The highest class-specific accuracy reached 89%, with a maximum sensitivity of 97% and an F1-score of 92%, demonstrating strong performance in identifying DR cases. These findings suggest that TL-based DR screening is a promising approach for early diagnosis, enabling timely interventions to prevent vision loss and improve patient outcomes.

Wavelet-based Global-Local Interaction Network with Cross-Attention for Multi-View Diabetic Retinopathy Detection

Multi-view diabetic retinopathy (DR) detection has recently emerged as a promising method to address the issue of incomplete lesions faced by single-view DR. However, it is still challenging due to the variable sizes and scattered locations of lesions. Furthermore, existing multi-view DR methods typically merge multiple views without considering the correlations and redundancies of lesion information across them. Therefore, we propose a novel method to overcome the challenges of difficult lesion information learning and inadequate multi-view fusion. Specifically, we introduce a two-branch network to obtain both local lesion features and their global dependencies. The high-frequency component of the wavelet transform is used to exploit lesion edge information, which is then enhanced by global semantic to facilitate difficult lesion learning. Additionally, we present a cross-view fusion module to improve multi-view fusion and reduce redundancy. Experimental results on large public datasets demonstrate the effectiveness of our method. The code is open sourced on https://github.com/HuYongting/WGLIN.

Limits of trust in medical AI

Artificial intelligence (AI) is expected to revolutionize the practice of medicine. Recent advancements in the field of deep learning have demonstrated success in a variety of clinical tasks: detecting diabetic retinopathy from images, predicting hospital readmissions, aiding in the discovery of new drugs, etc. AI's progress in medicine, however, has led to concerns regarding the potential effects of this technology upon relationships of trust in clinical practice. In this paper, I will argue that there is merit to these concerns, since AI systems can be relied upon, and are capable of reliability, but cannot be trusted, and are not capable of trustworthiness. Insofar as patients are required to rely upon AI systems for their medical decision-making, there is potential for this to produce a deficit of trust in relationships in clinical practice.

AI-Driven Diabetic Retinopathy Diagnosis Enhancement through Image Processing and Salp Swarm Algorithm-Optimized Ensemble Network

Diabetic retinopathy is a leading cause of blindness in diabetic patients and early detection plays a crucial role in preventing vision loss. Traditional diagnostic methods are often time-consuming and prone to errors. The emergence of deep learning techniques has provided innovative solutions to improve diagnostic efficiency. However, single deep learning models frequently face issues related to extracting key features from complex retinal images. To handle this problem, we present an effective ensemble method for DR diagnosis comprising four main phases: image pre-processing, selection of backbone pre-trained models, feature enhancement, and optimization. Our methodology initiates with the pre-processing phase, where we apply CLAHE to enhance image contrast and Gamma correction is then used to adjust the brightness for better feature recognition. We then apply Discrete Wavelet Transform (DWT) for image fusion by combining multi-resolution details to create a richer dataset. Then, we selected three pre-trained models with the best performance named DenseNet169, MobileNetV1, and Xception for diverse feature extraction. To further improve feature extraction, an improved residual block is integrated into each model. Finally, the predictions from these base models are then aggregated using weighted ensemble approach, with the weights optimized by using Salp Swarm Algorithm (SSA).SSA intelligently explores the weight space and finds the optimal configuration of base architectures to maximize the performance of the ensemble model. The proposed model is evaluated on the multiclass Kaggle APTOS 2019 dataset and obtained 88.52% accuracy.

Context-Aware Vision Language Foundation Models for Ocular Disease Screening in Retinal Images

Foundation models are large-scale versatile systems trained on vast quantities of diverse data to learn generalizable representations. Their adaptability with minimal fine-tuning makes them particularly promising for medical imaging, where data variability and domain shifts are major challenges. Currently, two types of foundation models dominate the literature: self-supervised models and more recent vision-language models. In this study, we advance the application of vision-language foundation (VLF) models for ocular disease screening using the OPHDIAT dataset, which includes nearly 700,000 fundus photographs from a French diabetic retinopathy (DR) screening network. This dataset provides extensive clinical data (patient-specific information such as diabetic health conditions, and treatments), labeled diagnostics, ophthalmologists text-based findings, and multiple retinal images for each examination. Building on the FLAIR model $\unicode{x2013}$ a VLF model for retinal pathology classification $\unicode{x2013}$ we propose novel context-aware VLF models (e.g jointly analyzing multiple images from the same visit or taking advantage of past diagnoses and contextual data) to fully leverage the richness of the OPHDIAT dataset and enhance robustness to domain shifts. Our approaches were evaluated on both in-domain (a testing subset of OPHDIAT) and out-of-domain data (public datasets) to assess their generalization performance. Our model demonstrated improved in-domain performance for DR grading, achieving an area under the curve (AUC) ranging from 0.851 to 0.9999, and generalized well to ocular disease detection on out-of-domain data (AUC: 0.631-0.913).

A graph neural network-based multispectral-view learning model for diabetic macular ischemia detection from color fundus photographs

Diabetic macular ischemia (DMI), marked by the loss of retinal capillaries in the macular area, contributes to vision impairment in patients with diabetes. Although color fundus photographs (CFPs), combined with artificial intelligence (AI), have been extensively applied in detecting various eye diseases, including diabetic retinopathy (DR), their applications in detecting DMI remain unexplored, partly due to skepticism among ophthalmologists regarding its feasibility. In this study, we propose a graph neural network-based multispectral view learning (GNN-MSVL) model designed to detect DMI from CFPs. The model leverages higher spectral resolution to capture subtle changes in fundus reflectance caused by ischemic tissue, enhancing sensitivity to DMI-related features. The proposed approach begins with computational multispectral imaging (CMI) to reconstruct 24-wavelength multispectral fundus images from CFPs. ResNeXt101 is employed as the backbone for multi-view learning to extract features from the reconstructed images. Additionally, a GNN with a customized jumper connection strategy is designed to enhance cross-spectral relationships, facilitating comprehensive and efficient multispectral view learning. The study included a total of 1,078 macula-centered CFPs from 1,078 eyes of 592 patients with diabetes, of which 530 CFPs from 530 eyes of 300 patients were diagnosed with DMI. The model achieved an accuracy of 84.7 percent and an area under the receiver operating characteristic curve (AUROC) of 0.900 (95 percent CI: 0.852-0.937) on eye-level, outperforming both the baseline model trained from CFPs and human experts (p-values less than 0.01). These findings suggest that AI-based CFP analysis holds promise for detecting DMI, contributing to its early and low-cost screening.

Is an Ultra Large Natural Image-Based Foundation Model Superior to a Retina-Specific Model for Detecting Ocular and Systemic Diseases?

The advent of foundation models (FMs) is transforming medical domain. In ophthalmology, RETFound, a retina-specific FM pre-trained sequentially on 1.4 million natural images and 1.6 million retinal images, has demonstrated high adaptability across clinical applications. Conversely, DINOv2, a general-purpose vision FM pre-trained on 142 million natural images, has shown promise in non-medical domains. However, its applicability to clinical tasks remains underexplored. To address this, we conducted head-to-head evaluations by fine-tuning RETFound and three DINOv2 models (large, base, small) for ocular disease detection and systemic disease prediction tasks, across eight standardized open-source ocular datasets, as well as the Moorfields AlzEye and the UK Biobank datasets. DINOv2-large model outperformed RETFound in detecting diabetic retinopathy (AUROC=0.850-0.952 vs 0.823-0.944, across three datasets, all P<=0.007) and multi-class eye diseases (AUROC=0.892 vs. 0.846, P<0.001). In glaucoma, DINOv2-base model outperformed RETFound (AUROC=0.958 vs 0.940, P<0.001). Conversely, RETFound achieved superior performance over all DINOv2 models in predicting heart failure, myocardial infarction, and ischaemic stroke (AUROC=0.732-0.796 vs 0.663-0.771, all P<0.001). These trends persisted even with 10% of the fine-tuning data. These findings showcase the distinct scenarios where general-purpose and domain-specific FMs excel, highlighting the importance of aligning FM selection with task-specific requirements to optimise clinical performance.

Object Detection for Medical Image Analysis: Insights from the RT-DETR Model

Deep learning has emerged as a transformative approach for solving complex pattern recognition and object detection challenges. This paper focuses on the application of a novel detection framework based on the RT-DETR model for analyzing intricate image data, particularly in areas such as diabetic retinopathy detection. Diabetic retinopathy, a leading cause of vision loss globally, requires accurate and efficient image analysis to identify early-stage lesions. The proposed RT-DETR model, built on a Transformer-based architecture, excels at processing high-dimensional and complex visual data with enhanced robustness and accuracy. Comparative evaluations with models such as YOLOv5, YOLOv8, SSD, and DETR demonstrate that RT-DETR achieves superior performance across precision, recall, mAP50, and mAP50-95 metrics, particularly in detecting small-scale objects and densely packed targets. This study underscores the potential of Transformer-based models like RT-DETR for advancing object detection tasks, offering promising applications in medical imaging and beyond.

Diabetic Retinopathy Detection Using CNN with Residual Block with DCGAN

Diabetic Retinopathy (DR) is a major cause of blindness worldwide, caused by damage to the blood vessels in the retina due to diabetes. Early detection and classification of DR are crucial for timely intervention and preventing vision loss. This work proposes an automated system for DR detection using Convolutional Neural Networks (CNNs) with a residual block architecture, which enhances feature extraction and model performance. To further improve the model's robustness, we incorporate advanced data augmentation techniques, specifically leveraging a Deep Convolutional Generative Adversarial Network (DCGAN) for generating diverse retinal images. This approach increases the variability of training data, making the model more generalizable and capable of handling real-world variations in retinal images. The system is designed to classify retinal images into five distinct categories, from No DR to Proliferative DR, providing an efficient and scalable solution for early diagnosis and monitoring of DR progression. The proposed model aims to support healthcare professionals in large-scale DR screening, especially in resource-constrained settings.