HIRD-Net: An Explainable CNN-Based Framework with Attention Mechanism for Diabetic Retinopathy Diagnosis Using...

Diabetic Retinopathy (DR) is a leading cause of vision impairment globally, underscoring the need for accurate and early diagnosis to prevent disease progression. Although fundus imaging serves as a cornerstone of Computer-Aided Diagnosis (CAD) systems, several challenges persist, including lesion scale variability, blurry morphological patterns, inter-class imbalance, limited labeled datasets, and computational inefficiencies. To address these issues, this study proposes an end-to-end diagnostic framework that integrates an enhanced preprocessing pipeline with a novel deep learning architecture, Hierarchical-Inception-Residual-Dense Network (HIRD-Net). The preprocessing stage combines Contrast Limited Adaptive Histogram Equalization (CLAHE) with Dilated Difference of Gaussian (D-DoG) filtering to improve image contrast and highlight fine-grained retinal structures. HIRD-Net features a hierarchical feature fusion stem alongside multiscale, multilevel inception-residual-dense blocks for robust representation learning. The Squeeze-and-Excitation Channel Attention (SECA) is introduced before each Global Average Pooling (GAP) layer to refine the Feature Maps (FMs). It further incorporates four GAP layers for multi-scale semantic aggregation, employs the Hard-Swish activation to enhance gradient flow, and utilizes the Focal Loss function to mitigate class imbalance issues. Experimental results on the IDRiD-APTOS2019, DDR, and EyePACS datasets demonstrate that the proposed framework achieves 93.46%, 82.45% and 79.94% overall classification accuracy using only 4.8 million parameters, highlighting its strong generalization capability and computational efficiency. Furthermore, to ensure transparent predictions, an Explainable AI (XAI) approach known as Gradient-weighted Class Activation Mapping (Grad-CAM) is employed to visualize HIRD-Net's decision-making process.