A hybrid deep learning metaheuristic model for diagnosis of diabetic retinopathy

Abstract

Diabetes is a disease that results in an increase in blood sugar due to the pancreas not producing enough insulin, insufficient effect of the produced insulin, or ineffective use of insulin. According to the International Diabetes Federation 2021 report, approximately 537 million adults aged between 20 and 79 live with diabetes worldwide. It is estimated that the number of people with diabetes will increase to 643 million in 2030 and 783 million in 2045. Diabetic retinopathy (DR) is an eye condition that can cause vision loss, irrecoverable visual deterioration, and blindness in people with diabetes. Today, it is one of the leading diseases that cause blindness. Anyone with any diabetes can become a DR. In ophthalmology, type 2 diabetes can lead to DR if left untreated for more than five years. Diabetes-related high blood sugar leads to DR. Over time, having too much sugar in the blood damages the retina. The deterioration of this disease in the eye begins when sugar blocks the capillaries leading to the retina, causing fluid leakage or bleeding at a later stage. The eye produces new vessels to compensate for the blocked vessels, but these newly formed vessels often do not work well and can bleed or leak easily. DR can lead to other serious eye conditions. For example, about one in 15 people with diabetes develop diabetic macular edema over time. DR can lead to the formation of abnormal blood vessels in the retina and prevent fluid from leaving the eye. That causes a type of glaucoma. It is crucial for people with diabetes to have a comprehensive eye examination at least once a year. Follow-up of diabetes; factors such as staying physically active, eating a healthy diet, and using medications regularly can stop the damage to the eye and help prevent or delay vision loss. Some risk factors increase the development of DR, such as pregnancy, uncontrolled diabetes, smoking addiction, hypertension, and high cholesterol. In addition to being detected by magnifying the pupil in eye examination, DR is also diagnosed with the help of image processing techniques. It is common to use fundus images obtained by fundus fluorescent angiography to detect DR and other retinal diseases. Nowadays, with the increasing number of patients and the developments in imaging technologies, disease detection from medical images by various methods has increased. Deep learning is one of the methods whose application area has increased exponentially in recent years. Deep learning is a subfield of machine learning; both are a subfield in artificial intelligence. Deep learning methods draw attention with their versatility, high performance, high generalization capacity, and multidisciplinary use. Technological developments such as the collection of large amounts of data, graphics processing units, the development of robust computer infrastructures, and cloud computing support the building and implementation of new models.Increasing the number of images for a particular patient case and high-resolution images increases specialists' workload. Diagnosis of DR manually by an ophthalmologist is an expensive and time-consuming process. It requires experts who have remarkable experience. In addition, the complexity of medical images and the variations between specialists make it difficult for radiologists and physicians to make efficient and accurate diagnoses at any time. Deep learning is promising in providing decision support to clinicians by increasing the accuracy and efficiency of diagnosis and treatment processes of various diseases. Today, in some medical studies, the success levels of expert radiologists have been achieved or exceeded. Convolutional neural networks (CNNs) are the most widely used deep learning networks in image recognition, image/object recognition, or classification studies. A CNN model doesn't need manually designed features for training; it extracts features from data directly while network training on images. The automated feature extraction property and their success make CNNs highly preferred models in computer vision tasks. This study proposes a hybrid model for the automatic diagnosis of DR. A binary classification of DR (referable vs. non-referable DR) is made using a deep CNN model, metaheuristic algorithms, and machine learning algorithms. A public dataset, Messidor-2, is used in experiments. The proposed model has four steps: preprocessing, feature extraction, feature selection, and classification. Firstly, fundus images are pre-processed by resizing images and normalizing pixel values. The inception-v3 model is applied with the transfer learning approach for feature extraction from processed images. Then, classification is made using machine learning algorithms: Extreme Gradient Boosting (XGBoost), Random Forest, Extra Trees, Bagged Decision Trees, Logistic Regression, Support Vector Machines, and Multilayer Perceptron. XGBoost gives maximum accuracy of 91.40%. The best potential features are selected from the extracted features by three metaheuristic algorithms: Particle Swarm Optimization, Simulated Annealing, and Artificial Bee Colony. Selected features are classified with the XGBoost algorithm. The metaheuristics significantly reduced the number of features obtained from each fundus image and increased the classification accuracy. According to the results, the highest accuracy of 93.12% is obtained from the features selected with Particle Swarm Optimization. When the study results are compared with the existing studies in the literature, it has shown that this study is competitive in terms of accuracy performance and obtained low features. On the other hand, the proposed model has some advantages; it has a few pre-processing steps, training number of parameters are considerable low, and model can be trained with a small amount of data. This study is one of the first studies showing that better results can be obtained in DR classification by using deep learning and metaheuristic algorithms together. The proposed model can be used to give another idea for ophthalmologists in diagnosing DR.