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Hybrid deep learning models for diabetic retinopathy stage classification using fundus images
Amira Echtioui1, Fathi Kallel2
1National School of Advanced Sciences and Technologies (ENSTA) of Borj Cedria, Hammam-Chott, BP 122, 1164 Tunisia.
Journal of Diabetes and Metabolic Disorders
|July 1, 2026
Summary
Hybrid deep learning and machine learning models accurately classify diabetic retinopathy (DR) stages from retinal images. These automated tools aid early detection and management, improving patient outcomes and supporting ophthalmologists.
Area of Science:
- Ophthalmology
- Medical Imaging
- Artificial Intelligence
Background:
- Diabetic retinopathy (DR) is a primary cause of vision loss in diabetic patients.
- Early detection and accurate staging of DR are crucial for preventing severe visual impairment.
- Automated classification systems can aid clinicians in timely DR diagnosis and management.
Purpose of the Study:
- To develop and evaluate hybrid deep learning and machine learning models for automated diabetic retinopathy stage classification.
- To assess the performance of different hybrid architectures using retinal fundus images.
- To enhance model interpretability using visualization techniques.
Main Methods:
- Utilized deep learning (MobileNetV2, VGG16) for feature extraction from retinal fundus images.
- Combined deep learning features with traditional classifiers (Support Vector Machine, Random Forest).
- Applied Grad-CAM and Score-CAM for visualizing image regions influencing predictions.
Main Results:
- Hybrid models achieved high performance on the APTOS 2019 dataset.
- MobileNetV2+SVM and MobileNetV2+RF both attained 85% accuracy.
- The models demonstrated reliable and interpretable predictions for DR staging.
Conclusions:
- Lightweight Convolutional Neural Networks (CNNs) coupled with traditional classifiers offer effective DR stage prediction.
- The proposed hybrid approach provides accurate, transparent, and efficient tools for clinical support.
- Future research will focus on improving generalizability and clinical integration.