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 timeconsuming 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.