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Retinal fundus imaging plays an essential role in diagnosing various stages of diabetic retinopathy, where exudates are critical markers of early disease onset. Prompt detection of these exudates is pivotal for enabling optometrists to arrest or significantly decelerate the disease progression. This paper introduces a novel, lightweight convolutional neural network architecture tailored for automated exudate detection, designed to identify these markers efficiently and accurately. To address the challenge of limited training data, we have incorporated domain-specific data augmentations to enhance the model's generalizability. Furthermore, we applied a suite of regularization techniques within our custom architecture to boost diagnostic accuracy while optimizing computational efficiency. Remarkably, this streamlined model contains only 4.73 million parameters a reduction of nearly 60% compared to the standard ResNet-18 model, which has 11.69 million parameters. Despite its reduced complexity, our model achieves an impressive F1 score of 90%, demonstrating its efficacy in the early detection of diabetic retinopathy through fundus imaging.

Deep learning brought boosts to auto diabetic retinopathy (DR) diagnosis, thus, greatly helping ophthalmologists for early disease detection, which contributes to preventing disease deterioration that may eventually lead to blindness. It has been proved that convolutional neural network (CNN)-aided lesion identifying or segmentation benefits auto DR screening. The key to fine-grained lesion tasks mainly lies in: (1) extracting features being both sensitive to tiny lesions and robust against DR-irrelevant interference, and (2) exploiting and re-using encoded information to restore lesion locations under extremely imbalanced data distribution. To this end, we propose a CNN-based DR diagnosis network with attention mechanism involved, termed lesion-aware network, to better capture lesion information from imbalanced data. Specifically, we design the lesion-aware module (LAM) to capture noise-like lesion areas across deeper layers, and the feature-preserve module (FPM) to assist shallow-to-deep feature fusion. Afterward, the proposed lesion-aware network (LANet) is constructed by embedding the LAM and FPM into the CNN decoders for DR-related information utilization. The proposed LANet is then further extended to a DR screening network by adding a classification layer. Through experiments on three public fundus datasets with pixel-level annotations, our method outperforms the mainstream methods with an area under curve of 0.967 in DR screening, and increases the overall average precision by 7.6%, 2.1%, and 1.2% in lesion segmentation on three datasets. Besides, the ablation study validates the effectiveness of the proposed sub-modules., Comment: This is submitted version wihout improvements by reviewers. The final version is published on International Journal of Imaging Systems and Techonology (https://onlinelibrary.wiley.com/doi/10.1002/ima.22933)

Diabetic Retinopathy (DR), an ocular complication of diabetes, is a leading cause of blindness worldwide. Traditionally, DR is monitored using Color Fundus Photography (CFP), a widespread 2-D imaging modality. However, DR classifications based on CFP have poor predictive power, resulting in suboptimal DR management. Optical Coherence Tomography Angiography (OCTA) is a recent 3-D imaging modality offering enhanced structural and functional information (blood flow) with a wider field of view. This paper investigates automatic DR severity assessment using 3-D OCTA. A straightforward solution to this task is a 3-D neural network classifier. However, 3-D architectures have numerous parameters and typically require many training samples. A lighter solution consists in using 2-D neural network classifiers processing 2-D en-face (or frontal) projections and/or 2-D cross-sectional slices. Such an approach mimics the way ophthalmologists analyze OCTA acquisitions: 1) en-face flow maps are often used to detect avascular zones and neovascularization, and 2) cross-sectional slices are commonly analyzed to detect macular edemas, for instance. However, arbitrary data reduction or selection might result in information loss. Two complementary strategies are thus proposed to optimally summarize OCTA volumes with 2-D images: 1) a parametric en-face projection optimized through deep learning and 2) a cross-sectional slice selection process controlled through gradient-based attribution. The full summarization and DR classification pipeline is trained from end to end. The automatic 2-D summary can be displayed in a viewer or printed in a report to support the decision. We show that the proposed 2-D summarization and classification pipeline outperforms direct 3-D classification with the advantage of improved interpretability.

Deep learning classifiers provide the most accurate means of automatically diagnosing diabetic retinopathy (DR) based on optical coherence tomography (OCT) and its angiography (OCTA). The power of these models is attributable in part to the inclusion of hidden layers that provide the complexity required to achieve a desired task. However, hidden layers also render algorithm outputs difficult to interpret. Here we introduce a novel biomarker activation map (BAM) framework based on generative adversarial learning that allows clinicians to verify and understand classifiers decision-making. A data set including 456 macular scans were graded as non-referable or referable DR based on current clinical standards. A DR classifier that was used to evaluate our BAM was first trained based on this data set. The BAM generation framework was designed by combing two U-shaped generators to provide meaningful interpretability to this classifier. The main generator was trained to take referable scans as input and produce an output that would be classified by the classifier as non-referable. The BAM is then constructed as the difference image between the output and input of the main generator. To ensure that the BAM only highlights classifier-utilized biomarkers an assistant generator was trained to do the opposite, producing scans that would be classified as referable by the classifier from non-referable scans. The generated BAMs highlighted known pathologic features including nonperfusion area and retinal fluid. A fully interpretable classifier based on these highlights could help clinicians better utilize and verify automated DR diagnosis., Comment: This paper has been accepted by IEEE TBME

Diabetic Retinopathy (DR) is a complication of long-standing, unchecked diabetes and one of the leading causes of blindness in the world. This paper focuses on improved and robust methods to extract some of the features of DR, viz. Blood Vessels and Exudates. Blood vessels are segmented using multiple morphological and thresholding operations. For the segmentation of exudates, k-means clustering and contour detection on the original images are used. Extensive noise reduction is performed to remove false positives from the vessel segmentation algorithm's results. The localization of Optic Disc using k-means clustering and template matching is also performed. Lastly, this paper presents a Deep Convolutional Neural Network (DCNN) model with 14 Convolutional Layers and 2 Fully Connected Layers, for the automatic, binary diagnosis of DR. The vessel segmentation, optic disc localization and DCNN achieve accuracies of 95.93%, 98.77% and 75.73% respectively. The source code and pre-trained model are available https://github.com/Sohambasu07/DR_2021, Comment: RAAI 2020, 11 pages, 12 figures, 2 tables

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., Comment: 20 pages, 6 figures

In recent years, Artificial Intelligence (AI) has proven its relevance for medical decision support. However, the "black-box" nature of successful AI algorithms still holds back their wide-spread deployment. In this paper, we describe an eXplanatory Artificial Intelligence (XAI) that reaches the same level of performance as black-box AI, for the task of classifying Diabetic Retinopathy (DR) severity using Color Fundus Photography (CFP). This algorithm, called ExplAIn, learns to segment and categorize lesions in images; the final image-level classification directly derives from these multivariate lesion segmentations. The novelty of this explanatory framework is that it is trained from end to end, with image supervision only, just like black-box AI algorithms: the concepts of lesions and lesion categories emerge by themselves. For improved lesion localization, foreground/background separation is trained through self-supervision, in such a way that occluding foreground pixels transforms the input image into a healthy-looking image. The advantage of such an architecture is that automatic diagnoses can be explained simply by an image and/or a few sentences. ExplAIn is evaluated at the image level and at the pixel level on various CFP image datasets. We expect this new framework, which jointly offers high classification performance and explainability, to facilitate AI deployment.

Diabetic Retinopathy DR is a popular disease for many people as a result of age or the diabetic, as a result, it can cause blindness. therefore, diagnosis of this disease especially in the early time can prevent its effect for a lot of patients. To achieve this diagnosis, eye retina must be examined continuously. Therefore, computer-aided tools can be used in the field based on computer vision techniques. Different works have been performed using various machine learning techniques. Convolutional Neural Network is one of the promise methods, so it was for Diabetic Retinopathy detection in this paper. Also, the proposed work contains visual enhancement in the pre-processing phase, then the CNN model is trained to be able for recognition and classification phase, to diagnosis the healthy and unhealthy retina image. Three public dataset DiaretDB0, DiaretDB1 and DrimDB were used in practical testing. The implementation of this work based on Matlab- R2019a, deep learning toolbox and deep network designer to design the architecture of the convolutional neural network and train it. The results were evaluated to different metrics; accuracy is one of them. The best accuracy that was achieved: for DiaretDB0 is 100%, DiaretDB1 is 99.495% and DrimDB is 97.55%., Comment: 8 pages

Diabetic Retinopathy (DR) is one of the microvascular complications of Diabetes Mellitus, which remains as one of the leading causes of blindness worldwide. Computational models based on Convolutional Neural Networks represent the state of the art for the automatic detection of DR using eye fundus images. Most of the current work address this problem as a binary classification task. However, including the grade estimation and quantification of predictions uncertainty can potentially increase the robustness of the model. In this paper, a hybrid Deep Learning-Gaussian process method for DR diagnosis and uncertainty quantification is presented. This method combines the representational power of deep learning, with the ability to generalize from small datasets of Gaussian process models. The results show that uncertainty quantification in the predictions improves the interpretability of the method as a diagnostic support tool. The source code to replicate the experiments is publicly available at https://github.com/stoledoc/DLGP-DR-Diagnosis.

Although deep learning research and applications have grown rapidly over the past decade, it has shown limitation in healthcare applications and its reachability to people in remote areas. One of the challenges of incorporating deep learning in medical data classification or prediction is the shortage of annotated training data in the healthcare industry. Medical data sharing privacy issues and limited patient population size can be stated as some of the reasons for training data insufficiency in healthcare. Methods to exploit deep learning applications in healthcare have been proposed and implemented in this dissertation. Traditional diagnosis of diabetic retinopathy requires trained ophthalmologists and expensive imaging equipment to reach healthcare centres in order to provide facilities for treatment of preventable blindness. Diabetic people residing in remote areas with shortage of healthcare services and ophthalmologists usually fail to get periodical diagnosis of diabetic retinopathy thereby facing the probability of vision loss or impairment. Deep learning and mobile application development have been integrated in this dissertation to provide an easy to use point-of-care smartphone based diagnosis of diabetic retinopathy. In order to solve the challenge of shortage of healthcare centres and trained ophthalmologists, the standalone diagnostic service was built so as to be operated by a non-expert without an internet connection. This approach could be transferred to other areas of medical image classification., Comment: Dissertation for a Masters of Technology in Data Science