Diabetic Retinopathy Using Deep Learning

Yenugonda Prathyusha Ravi Kakarla

Dept. Of Computer Science and Engineering Dept. Of Computer Science and Engineering
Hindustan Institute of Technology and Science Hindustan Institute of Technology and Science
Chennai, India Chennai, India
prathyushayenugonda@gmail.com prathyushayenugonda@gmail.com

J. Swarnalakshmi
Department of Computer Science and Engineering
Hindustan Institute of Technology and Science
Chennai, India
swarnalakshmijr@gmail.com

Abstract: Deep learning (DL) enables the creation of
computational models comprising multiple processing
layers that learn data representations at multiple levels
of abstraction. In the recent past, the use of deep
learning has been proliferating, yielding promising
results in applications across a growing number of
fields, most notably in image processing, medical image
analysis, data analysis, and bioinformatics. DL
algorithms have also had a significant positive impact
through yielding improvements in screening,
recognition, segmentation, prediction, and classification
applications across different domains of healthcare,
such as those concerning the abdomen, cardiac,
pathology, and retina. Given the extensive body of
recent scientific contributions in this discipline, a
comprehensive review of deep learning developments in
the domain of diabetic retinopathy (DR) analysis, viz.,
screening, segmentation, prediction, classification, and
validation, is presented here. A critical analysis of the
relevant reported techniques is carried out, and the
associated advantages and limitations highlighted,
culminating in the identification of research gaps and
future challenges that help to inform the research
community to develop more efficient, robust, and
accurate DL models for the various challenges in the
monitoring and diagnosis of DR.
keyword: Dataset of retinal images, CNN
I. INTRODUCTION
Diabetes is a long-term blood sugar disorder that
impairs an individual/s body's capacity to use blood
sugar efficiently. This is primarily due to a decrease
in insulin synthesis in the body. When the cells stop
responding to insulin, too much blood sugar is
present in the person's bloodstream. This further
causes health issues such as cardiovascular disease,
loss of eyesight, and renal disease. Hence, the early
detection of diabetes is crucial as medical
intervention can avert significant repercussions.
Diabetes is classified into Type 1, Type 2 and
"Gestational diabetes".
Diabetes type 1: Children and teens are most
typically diagnosed with type 1 diabetes. When an
individual has diabetes type 1, their immune system
targets the pancreatic cells that produce insulin.
Diabetes type 2: Type 2 diabetes is caused when an
individual's body stops reacting to the insulin
produced by the pancreas. The pancreas eventually
quits making enough insulin. It's usually caused by a
mix of hereditary and environmental factors.

Gestational Diabetes: also known as Diabetes that is
caused during pregnancy. This kind of diabetes is
caused by hormonal changes that occur during
pregnancy.
Placental hormones can reduce the body's sensitivity
to insulin. This can lead to elevated blood sugar
levels during pregnancy.
A. DIABETIC RETINOPATHY
Individuals with diabetes are prone to Diabetic
retinopathy, which is an eye disorder. When this
happens, elevated blood sugar levels harm the retina's
blood vessels. They have the potential to expand and
leak. Alternatively, they could close, preventing
blood flow. On the retina, abnormally new blood
vessels can occasionally form. These various changes
can adversely affect the eyesight of the person, for a
visual understanding. Early stages of Diabetic
Retinopathy show no significant symptoms. Some
individuals, however, experience changes in vision.
During the later stages of DR, the retinal blood
vessels start to leak into the vitreous, which is a gel-
like fluid that fills an eye, this leads to the
development of cobweb like black streaks which is
mainly caused due to blood clots and other blood
fluids. It is important to seek medical help
immediately as if left untreated, it might cause
scarring in the eye. Furthermore, the leaking of these
blood vessels might worsen. Early detection of the
disease can slow down its impact of the disease and
the development of DR into a more advanced
eyesight-threatening form can be prevented.
There are two main stages of DR based on the extent
of damage, these are:
A. NPDR (non-proliferative diabetic retinopathy):
The retinal blood vessels begin to deteriorate during
this stage of DR, and minute bulges occasionally
erupt from the smaller arteries, which leads to fluid
and blood being leaked into the retina. The diameter
of larger retinal vessels might also start to enlarge
and change. NPDR can worsen when more blood
vessels are blocked, going from mild to severe. There
may occasionally be the accumulation of oedema in
the macular region of the retina because of retinal
blood vessel injury. Treatment is needed if macular
oedema impairs vision to prevent irreversible vision
loss. There may occasionally be an accumulation of
fluid (oedema) in the macular region of the retina
because of retinal blood vessel injury. Treatment is
needed if macular oedema impairs vision to prevent
irreversible vision loss.
B. PDR (proliferative diabetic retinopathy):
PDR is a serious form of diabetic retinopathy as
compared to NPDR. It causes the development of
new blood vessels in the retina. As these new blood
vessels are feeble, the blood fluid might leak from
them into the vitreous that makes up the internal parts
of the eye.
These new blood vessels produce scar tissue, which
eventually leads to the retina being separated from
the back of the eye. The eyeball may become
pressurized if the new blood vessels obstruct the
usual drainage of fluid from the eye. Glaucoma can
develop because of this accumulation harming the
optic nerve, which delivers images from your eye to
your brain.
Risk Factors: Factors that can increase the risk of
developing DR in an individual is:
a. Poor control of blood sugar level
b. High BP
c. Pregnancy
d. Inflated Cholesterol
e. The use of Tobacco.
DR can also lead to various complications, some of
which are:
1) Vitreous hemorrhage: Vitreous is a clear fluid that
is present at the center of the eye. This complication
occurs when the newly developed blood vessels bleed
into the vitreous. An individual might end up seeing a
few dark spots if the bleeding is minimal.
2) Retinal detachment: These new blood vessels
produce scar tissue, which eventually leads to the
retina being separated from the back of the eye. This
leads to vision loss, flashes of light etc.
3) Glaucoma: The pressure in the eye increases when
the new blood vessels end up interfering with the
flow of fluid out of the eye. The optic nerve can
result in being damaged due to this pressure.
4) Blindness: Conditions such as Diabetic
retinopathy, macular oedema, and glaucoma can lead
to vision loss.
II. LITERATURE SURVEY
1. Suvajit et al., used 1000 retinal pictures which
were subjected to the back propagation technique in
neural networks, deep neural networks,
convolutional neural networks. Starting with
extracting the statistical features of the RGB and then
converting the RGB image to grayscale for image
filtering, feature extraction by applying edge
detection and finally, binary conversion of the image
so that the features are highlighted. The statistical
data was taken into consideration for image
classification with FNN.
The same is done for DNN and the results were
compared. Similarly, the results were also compared
with FNN and DNN for image classification. They
achieved 62.7%, 89.6% and 76.4% accuracies in
training and 42%, 86.3% and 78.3% in testing
accuracies employing neural network
backpropagation methods, deep neural networks, and
convolutional neural networks, respectively, in
accuracy testing.
2. Revathy et al. presented an ML method which
extracts three features, namely, exudates,
hemorrhages and microaneurysms. It classifies DR
using a hybrid classifier which is nothing but a
combination of SVM, KNN, Random Forest, Logistic
Regression and Multilayer Perceptron network. It is
inferred that the Random Forest Classifier gives an
accuracy of 90% and it is noticed that it shows the
most accuracy when compared to SVM (68%
accuracy) and KNN (76% Accuracy). 36 of the 49
test samples made the right predictions. The authors
of this paper [8] have proposed two methods, in the
first method, they use a shallow neural network
architecture. For most frequent classes, this model
does well for classification however, it fails to
classify the infrequent classes. For the next approach,
they use transfer learning, which is used to retrain the
rearmost layer of a deep neural network. The Shallow
and neural network method has an accuracy of 72.35%,
67.05%, and 69.03% on the train, validation, and test
sets respectively. The transferred learning method has
an accuracy of 80.85%, 80.60%, 77.87% for the train
set, validation set and test set respectively. According
to the accuracies that were obtained during the
experimentation we can observe that the second
method gave a better accuracy even for the less Developing a Deep Learning model for Diabetic
frequent classes. Retinopathy involves several steps, from data
collection to model evaluation. Here’s a general
workflow:

3. Khalid et al, collected data from 327 patients using Data Collection:

a random sampling technique with proportional Gather a dataset of retinal images labeled with
allocation. They have used a 10-fold cross-validation diabetic retinopathy stages. Myelinated nerve fiber,

resampling technique that was repeated 100 times. In Preretinal hemorrhage, Normal, VKH disease. This

the end, the accuracy of the respective classifier from dataset should be sufficiently large and diverse to

each iteration is averaged for that specific run. DR capture various manifestations of the disease. dataset

was classified using different methods such as SVM, containing retinal images labeled with diabetic

LDA, KNN, RF and RRF. RRF outperformed the retinopathy stages, as well as other conditions like

other classifiers by achieving an accuracy of 86%. myelinated nerve fiber, Preretinal hemorrhage, and

The algorithm also identified HbA1c and duration of VKH disease, one may embark on a quest through the

diabetes as the most discriminating interpretable vast realm of online data repositories, with Kaggle

features for classifying DR. being a prominent kingdom to explore. Within the
vast corridors of Kaggle's repositories lie datasets that

III. WORK FLOW: may hold the visual tapestry of retinal images
adorned with the intricate patterns of diabetic
retinopathy and its varying stages, alongside the
peculiar manifestations of myelinated nerve fiber,
Preretinal hemorrhage, and VKH disease.

Data Preprocessing:

Preprocess and augment your diabetic retinopathy

dataset. Split the data into training, validation, and
test sets. Preprocessing is done through resize method
and grayscale image.

Preprocessing entails the harmonization of disparate

elements within the dataset to foster uniformity and
clarity, akin to refining raw ore into gleaming gold.
In the context of retinal images, preprocessing may
involve several transformative steps, including
Grayscale conversion
Resizing images ensures uniformity in
dimensionality, akin to sculpting raw marble into
uniform blocks. This process not only conserves
computational resources but also facilitates seamless
integration into machine learning frameworks.
Preprocessing in Convolutional Neural Networks
(CNNs) is a critical step that prepares raw input data,
such as images, for effective training and inference.
In the realm of CNNs, preprocessing serves to
enhance the network's ability to extract meaningful
features from the data while mitigating potential
sources of noise and variance.
Resizing is a fundamental preprocessing step aimed
at ensuring uniformity in the dimensions of input
images. In CNNs, input images often need to have
consistent sizes to facilitate efficient computation and
parameter sharing across layers. Resizing also helps
prevent computational inefficiencies and memory
constraints. Typically, images are resized to a
predetermined fixed size, such as 224x224 pixels or
256x256 pixels, depending on the requirements of the
CNN architecture being used.
Normalization:
Normalization standardizes the pixel values of input
images to a common scale, usually within the range
of [0, 1] or [-1, 1]. This step aids in stabilizing the
training process by ensuring that input features have
similar magnitudes, which helps prevent issues such
as vanishing or exploding gradients during back
propagation. Normalization can be performed by
dividing the pixel values by the maximum intensity
value (e.g., 255 for 8-bit images) or by using
statistical properties of the dataset, such as mean and
standard deviation.
Grayscale conversion is relevant when working with
color images. In some cases, color information may
not be necessary for the task at hand, or using
grayscale images can reduce computational
complexity.
Grayscale Conversion
Grayscale conversion involves converting RGB
images to single-channel grayscale representations.
This simplifies the input data while preserving
essential image features, making it suitable for tasks
where color information is not critical.
Using two algorithms can provide diverse
perspectives and potentially enhance the overall
performance of your model. For example, let's
consider utilizing a Convolutional Neural Network
(CNN) and a pre-trained model like VGG16 in
tandem for image classification tasks. Here's how you
can approach it:
Design and implement a custom CNN architecture
tailored to your specific task and dataset. You can
define multiple convolutional layers, pooling layers,
and fully connected layers based on the complexity of
your data and the target classes.
Convolutional neural network
Custom CNN architecture
Design and implement a custom CNN architecture
tailored to your specific task and dataset. You can
define multiple convolutional layers, pooling layers,
and fully connected layers based on the complexity of
your data and the target classes.

Freezing Pretrained Layers

Freezing pretrained layers in a CNN involves

retaining the knowledge learned from a large dataset
during transfer learning. After loading a pretrained
model, new task-specific layers are added on top. To
prevent altering the pretrained layers, their weights
are set to be non-trainable, ensuring that only the
newly added layers are adjusted during training. This
Collecting a dataset of retinal images involves
practice helps prevent overfitting to the limited data
gathering a large set of high-quality images of the
of the new task, leveraging the general features
human retina for various purposes, such as medical
already captured. The frozen layers act as powerful
research, diagnostic tool development, or training
feature extractors, maintaining their ability to
machine learning models.
recognize patterns and structures from the original
Converting RGB (Red, Green, Blue) images to
training. This approach is particularly beneficial
grayscale is a common preprocessing step, especially
when working with smaller datasets, as it maximizes
in image analysis tasks.
the utilization of the pretrained model's learned
K-means clustering is a popular unsupervised
representations. The frozen layers serve as a robust
machine learning algorithm used for image
foundation, enhancing model performance and
segmentation and grouping similar data points. In the
speeding up convergence during training. The frozen
context of retinal images, K-means clustering can be
layers are typically chosen based on their position in
applied to group pixels or regions with similar
the network, considering whether they capture
characteristics.
generic or task-specific features. Overall, freezing
Fuzzy C-means (FCM) is a clustering algorithm that
pretrained layers is a strategic technique in transfer
is particularly useful for image segmentation tasks.
learning that strikes a balance between utilizing
Unlike the traditional K-means algorithm, Fuzzy C-
existing knowledge and adapting to a new task.
means allows each data point (in this case, pixels in a

classification retinal image) to belong to multiple clusters with

classification is done through the GUI (Graphical
user interface) load the image and preprocess the
image and segmentation and classify the retinal
image.
CNN Architecture:
varying degrees of membership. FCM assigns a
membership value to each pixel for each cluster,
indicating the degree to which the pixel belongs to
that cluster.
Predicting diabetic retinopathy from retinal images
using Convolutional Neural Networks (CNNs)
involves leveraging the power of deep learning to
automatically identify pathological changes
associated with diabetes in the retina. Diabetic
retinopathy is a common complication of diabetes
and can lead to vision impairment or blindness if not
detected and treated early. CNNs excel in learning
hierarchical features from images, making them well-
suited for tasks like image classification. In this
context, the CNN is trained on a dataset of labeled
retinal images, where each image is categorized
according to the severity of diabetic retinopathy. The
network learns to recognize distinctive patterns, such
as microaneurysms, hemorrhages, or exudates,
allowing it to make predictions based on unseen
images during the testing phase.
During the training process, the CNN optimizes its
internal parameters to accurately map retinal image
features to diabetic retinopathy severity levels. The
model's ability to generalize to new, unseen data is
crucial for its effectiveness in clinical applications.
Once trained and validated, the CNN can be
employed to predict the severity of diabetic
retinopathy in new retinal images, aiding healthcare
professionals in early diagnosis and timely
intervention. This approach holds the potential to
enhance the efficiency of diabetic retinopathy
screening programs, particularly in resource-
constrained environments, by providing a computer-
aided tool for identifying and prioritizing cases that
may require further examination by medical experts.
Methodology
In developing a deep learning model for Diabetic
Retinopathy (DR) using Convolutional Neural
Networks (CNNs), the methodology involves several
critical steps. Firstly, a robust dataset comprising
diverse retinal images, encompassing both normal
and diabetic retinopathy cases, is collected and
meticulously annotated for accurate labeling.
Subsequently, extensive data preprocessing
techniques are applied to standardize image sizes,
normalize pixel values, and augment the dataset to
enhance variability and robustness. These preparatory
steps ensure that the CNN model receives high-
quality input data representative of real-world
scenarios. Following data preparation, a suitable
CNN architecture is selected based on factors like
model complexity, performance, and computational
efficiency. with pre-trained models. This
initialization provides the model with a strong
foundation of learned features, which can be fine-
tuned to adapt to the specifics of diabetic retinopathy
classification. Through iterative training iterations,
the CNN learns to extract discriminative features
from retinal images, enabling accurate classification
of diabetic retinopathy severity levels.
Once the CNN architecture is defined and initialized,
the model undergoes training using the prepared
dataset. During training, optimization algorithms
such as stochastic gradient descent (SGD) or Adam
are employed to minimize a chosen loss function,
typically categorical cross-entropy, which quantifies
the disparity between predicted and ground-truth
labels. Regularization techniques, including dropout
and batch normalization, may also be applied to
prevent overfitting and improve generalization
performance. The training process is carefully
monitored using a separate validation dataset,
allowing for early detection of overfitting and fine-
tuning of hyperparameters as necessary. Finally, the
trained CNN model is evaluated on an independent
test set to assess its performance metrics, such as
accuracy. Ethical considerations regarding patient
privacy and data security are paramount throughout
the entire methodology, ensuring compliance with
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