Innovative Approach for Diabetic Retinopathy Severity Classification: An AI-Powered Tool using CNN-Transformer Fusion.

Background: Diabetic retinopathy (DR), a diabetes complication, causes blindness by damaging retinal blood vessels. While deep learning has advanced DR diagnosis, many models face issues like inconsistent performance, limited datasets, and poor interpretability, reducing their clinical utility.

Objective: This research aimed to develop and evaluate a deep learning structure combining Convolutional Neural Networks (CNNs) and transformer architecture to improve the accuracy, reliability, and generalizability of DR detection and severity classification.

Material and methods: This computational experimental study leverages CNNs to extract local features and transformers to capture long-range dependencies in retinal images. The model classifies five types of retinal images and assesses four levels of DR severity. The training was conducted on the augmented APTOS 2019 dataset, addressing class imbalance through data augmentation techniques. Performance metrics, including accuracy, Area Under the Curve (AUC), specificity, and sensitivity, were used for metric evaluation. The model's robustness was further validated using the IDRiD dataset under diverse scenarios.

Results: The model achieved a high accuracy of 94.28% on the APTOS 2019 dataset, demonstrating strong performance in both image classification and severity assessment. Validation on the IDRiD dataset confirmed its generalizability, achieving a consistent accuracy of 95.23%. These results indicate the model's effectiveness in accurately diagnosing and assessing DR severity across varied datasets.

Conclusion: The proposed Artificial intelligence (AI)-powered diagnostic tool improves diabetic patient care by enabling early DR detection, preventing progression and reducing vision loss. The proposed AI-powered diagnostic tool offers high performance, reliability, and generalizability, providing significant value for clinical DR management.