IAETSD JOURNAL FOR ADVANCED RESEARCH IN APPLIED SCIENCES, VOLUME 4, ISSUE 1, JAN-JUNE /2017

ISSN (ONLINE): 2394-8442

DIABETIC RETINOPATHY DETECTION USING TRANSFER

LEARNING
Lakshmi Govind [1], Dharmendra Kumar [2]
[1,2]
Department of Computer Science, United College of Engineering and Research, Naini, Allahabad
[1]
lakshmi.govind46@gmail.com , [2] kumar.dharmendra@rediffmail.com

ABSTRACT.

Transfer of knowledge increases the performance of deep learning-the technique used for image
classification tasks, including automated diabetic retinopathy screening. Deep learning greed for large amounts of
training data poses a challenge for medical tasks, which we can alleviate by recycling knowledge from models
trained on different tasks, in a scheme called transfer learning. Although much of transfer learning, a systematic
evaluation was not there. Here we investigate the presence of transfer, from which task the transfer is sourced, and
the application of the fine tuning. The performance of algorithms is compared and analyzed on two publicly
available databases KAGGLE of retinal images using a number of measures which include accuracy, true positive
rate, false positive rate, sensitivity, specificity.

KeywordsDeep Learning ,Convolutional Neural Networks, Transfer Learning, Automated Diabetic Retinopathy, Image
Classification,Diabetes.

I. INTRODUCTION
Diabetic retinopathy is the medical condition where the retina gets damaged due to leakage of blood vessels. Diabetic retinopathy (DR) is a
common retinal complication associated with diabetes. It is a major cause of blindness in both middle and advanced age groups. However,
efficient therapies do exist [1]. An accurate and early diagnosis and correct application of treatment can prevent blindness in more than 50% of
all cases According to the National Diabetes Information data (US).Diabetic retinopathy (damage to the retina) caused by complications of
diabetes, which can eventually lead to blindness [2]. It is an ocular appearance of diabetes, a universal disease, which affects up to 80 percent of
all patients who have had diabetes for 10 years or more. Although these intimidating statistics, research indicates that at least 90% of these new
cases could be reduced if there was proper and alert treatment and monitoring of the eyes. The longer a person has diabetes, the higher his or her
chances of developing diabetic retinopathy. In diabetic retinopathy there are some diseases like, Micro aneurysms; Micro aneurysms are the first
clinically detected lesions. It is tiny swelling in the wall of a blood vessel [3]. It appears in the retinal capillaries as a small, round, red spot
located in the inner nuclear layer of the retina. Hemorrhages, Hemorrhages are located in the middle layer of the retina. Retinal hemorrhage is
the abnormal bleeding of the blood vessels in the retina. Cotton Wool Spot, Cotton wool spots are an abnormal finding on fundoscopic exam of
the retina of the eye. They appear as fluffy white patches on the retina. They are caused by damage to nerve fibers and are a result of
accumulations of axoplasmic material within the nerve fiber layer. The nerve fibers are damaged by swelling in the surface layer of the retina.
Exudates are yellow flecks are called hard exudates. They are the lipid residues of serious leakage from damaged capillaries. The optic disc or
optic nerve head is the location where ganglion cell axons exit the eye to form the optic nerve. There are no light sensitive rods or cones to
respond to a light stimulus at this point. This causes a break in the visual field called "the blind spot" or the "physiological blind spot".

Classification of DR involves the weighting of numerous features and the location of such features. This is highly time consuming for clinicians.
Computers are able to obtain much quicker classifications once trained, giving the ability to aid clinicians in real-time classification. Significant
work has been done on detecting the features of DR using automated methods such a support vector machines and k-NN classifiers. The
majority of these classification techniques are on two class classification for DR or no DR. Convolutional Neural Networks (CNNs), a branch of
deep learning, have an impressive record for applications in image analysis and interpretation, including medical imaging. Network architectures
designed to work with image data were routinely built already in 1970s with useful applications and surpassed other approaches to challenging
tasks like handwritten character recognition. However, it wasnt until several breakthroughs in neural networks such as the implementation of
dropout [4], rectified linear units and the accompanying increase in computing power through graphical processor units (GPUs) that they became
viable for more complex image recognition problems. Presently, large CNNs are used to successfully tackle highly complex image recognition
tasks with many object classes; to an impressive standard. In this paper we introduce a deep learning-based CNN method with Transfer Learning
for the problem of classifying DR in fundus imagery. This is a medical imaging task with increasing diagnostic relevance, discussed earlier, and
one that has been subject to many studies in the past. Several new methods are introduced to adapt the CNN to our large dataset. Transfer
Learning, a technique where a model trained for a given source task is partiallyrecycled for a new target task [5]. Transfer Learning ranges
from simply using the output of the source DNNs as a feature vector, and training a completely new model for a target task; until using a pre-
trained source DNN and training the latter as usual.

To Cite This Article: Lakshmi Govind and Dharmendra Kumar,. DIABETIC RETINOPATHY DETECTION USING
TRANSFERS LEARNING. Journal for Advanced Research in Applied Sciences ;Pages: 463-471
464. Lakshmi Govind and Dharmendra Kumar,. DIABETIC RETINOPATHY DETECTION USING
TRANSFER LEARNING. Journal for Advanced Research in Applied Sciences; Pages: 463-471

II. DATASET
Data was drawn from a dataset maintained by EyePacs, and provided via Kaggle. The dataset is composed of multiple, smaller datasets of
fundus photographs drawn from various sources. Each image is assigned a class based on the presence and severity of DR where each image was
labeled by a trained clinician. There are total 35K images in the dataset with following distribution.

Class Number Percentage

0 25810 73.5%

1 2443 6.90%

2 5292 15.10%

3 873 2.50%

4 708 2.00%

Below Fig.1 are the examples of dataset images.

Fig.1 Dataset Images

The challenges presented by this task and dataset are numerous [6]. The dataset used is highly heterogeneous; the photographs are from different
sources, cameras, resolutions, and have vastly different degrees of noise and lighting. Resolutions ranged from 2592x1944 to 4752x3168. We
believe that being able to generalize to this noisy dataset adds to the value of the work done here, since the results would likely be more robust
and general.

III. LITERATURE SURVEY

1] Shuangling Wang, Yilon Yin, they used convolutional neural network and implement random forests for automatic blood vessel
segmentation. Convolutional neural network works as a trainable feature extractor and Random forest as a trainable traditional classifier.CNN
typically consists of a convolutional layer(c1,c3,c5), a sub sampling layer(s2,s4) , and a fully connected layer. Convolutional layer works as a
feature extraction layer. All neurons in a feature map share set of weights and the same bias. In this way, all neurons in a feature map detect the
same feature at different positions on the input [7]. Sub sampling layer (s) works as feature selection layer. They are used to reduce the spatial
resolution of each feature map. Fully connected layer is the standard layer of a multi-layer network. It performs a linear multiplication of the
input vector by a weight matrix. Random forest consists of tree predictors, where each tree depends on the values of a random vector sampled
independently and with the same distribution for all tree in the forest. Features learned from the same layer of CNN are fed into RF classifier.
For training process raw pixels values from a sub window centered on representative pixel sample are fed into CNN, when CNN is well trained
several RFs are trained with learned hierarchical features extracted from CNN. Finally ensemble method will predict that sub window is blood
vessel or not. For testing procedure sliding sub window sampling from the testing image are directly fed into CNN to extract the learned
hierarchical features then winner classifier is to used to predict result.

Fig.2 CNN followed by Random Forests

465. Lakshmi Govind and Dharmendra Kumar,. DIABETIC RETINOPATHY DETECTION USING
TRANSFER LEARNING. Journal for Advanced Research in Applied Sciences; Pages: 463-471

2] Harry Pratt, Frans Coenen, Broadbent, they propose a CNN approach to diagnosing DR from digital fundus images and accurately classifying
its severity. The structure [Fig 3] of the neural network was in such a way that increased convolutional layers is perceived to allow the network
to learn deeper features. The network starts with convolutional blocks with activation and then batch normalization after each convolutional
layer. They move to one batch normalization per block as the number of feature maps increases. They trained this network using high end GPU
on Kaggle dataset. Network was initially pretrained on 10,290 images for 120 epochs and later it was trained on full 78000 training images for
further 20 epochs. The network was trained using stochastic gradient descent with Nestrov momentum. Low learning Rate of 0.0001 was used
for 5 epochs to stabilize the weights. CNN achieves a sensitivity of 95% and an accuracy of 75% on 5,000 validation images.

3] Mrinal Haloi, she proposed a method where Micro aneurysm (MA) are detected using color fundus images. Each pixel of the image is
classified either as MA or non-MA using Deep Neural Network (DNN) [Fig.4] with dropout training procedure using maxout activation function
which increases the accuracy of the method.

Fig 4: DNN model

Fig.3 Network Architecture

This method performance is independent on vessel structures, the optic disc and the fovea. Micro aneurysms (MA) follow a Gaussian-like
intensity distribution and have isolated structures from neighbors. For a given pixel, class label is predicted using three color channel RGB
values. In a square window centered on that pixel of size w. Fig.3 shows an overview of the method. A DNN comprised of convolutional layer
alternate with max-pooling layer followed by fully connected layers and a final classification layer.
466. Lakshmi Govind and Dharmendra Kumar,. DIABETIC RETINOPATHY DETECTION USING
TRANSFER LEARNING. Journal for Advanced Research in Applied Sciences; Pages: 463-471

[4] T Chandra Kumar used deep convolutional neural network for the classification of disease severity from the fundus images. The model
comprises of following steps:

a. Data augmentation
b. Preprocessing
c. Deep Convolutional Network

The fundus images are collected from various datasets with varying field of view, non-clarity contrast and of different sizes. Steps involved in
preprocessing is resizing of images, converting the images into gray scale and then convert into L model and at last flatten the images in single
dimensional for processing further.

Common layers in DCNN are Convolutional Layer, Pooling Layer, ReLU Layer, Dropout Layer, Fully connected layer and classification Layer.
Convolutional Layer consists of set of filters. Each filter is convolved against the input image and extracts the features by forming a activation
map. Each activation map represents features of the input image. N*N input layer is convoluted with m*m filter. Then, the convolutional layer
output will be of size (N-m+1)*(N-m+1).

Pooling layer works as a form of non-linearity down sampling. Pooling partition the activation maps into set of rectangles and collect the
maximum value in the sub region. Rectified Linear Unit (ReLU) layer is an activation function. This activation map induces the sparsity in the
hidden units.

Dropout layer drops the parameter generated in each stacked layers which may cause over-fitting. A fully connected layer takes all neurons in
the previous layer from max-polling layer and connects it to every neuron it has and visualizes as one dimensional layer. The final layer is a
soft-max layer which stacked at the end for classifying the fundus image followed by the fully connected layer output. They considered
Specificity, Sensitivity and accuracy as the parameters for deciding the algorithm. Four parameters which take part in measuring those
performances are:

True Positive (TP) - Correctly detected DR images

True Negative (TN) - Correctly detected Non-DR images
False Positive (FP) - Number of Non-DR images are detected wrongly as DR images
False Negative (FN) - Number of DR images are detected wrongly as Non-DR images

At last, the Sensitivity, Specificity and Accuracy are measured for each fundus images available in the database.

Sensitivity (true positive rate or recall) measures how likely the test is positive who someone have a diabetic retinopathy. Specificity (true
negative rate) measures how likely the test is someone dont have the diabetic retinopathy. Positive predictive value is also called as Precision.
Accuracy measures the diabetic and non-diabetic patients from the database.

[5] Kanika Verma, Prakash Deep, to classify into stages of DR, they have focused on detection and quantification of blood vessels and
hemorrhages present in the image. Retinal vascular is segmented utilizing the contrast between the blood vessels and surrounding background.
Hemorrhages were detected using density analysis and bounding box techniques. Finally, classification of the different stages of eye disease was
done using Random Forest techniques based on the area and perimeter of the blood vessels and hemorrhages.

Blood Vessel Detection

There are three properties of the blood vessels in retinal images that help in differentiating them from other features:

1. The anti-parallel pairs can be approximated by piecewise linear segments due to small curvatures present in the blood vessels.
2. Vessel has lower reflectance compared to other retinal surfaces, so they appear darker relative to the background.
3. Although the width of a vessel decreases as it travels radially outward from the optic disk, such a change in vessel caliber is a gradually
one. In a RGB retinal image, adaptive histogram equalization was used to enhance the contrast of the features of interest against the
background. A 3*3 median filter was used to remove the random noise. Blood vessels were detected after applying the designed matched
filter where it was converted to binary equivalent with a global threshold value of 0.1490 where presence of discontinuous line were
observed.

Hemorrhage Detection
This follows four stages: 1) image digitization, 2) detection of hemorrhages 3) elimination of FPs (false positive) in blood vessels and 4)
elimination of FPs by feature analysis.
467. Lakshmi Govind and Dharmendra Kumar,. DIABETIC RETINOPATHY DETECTION USING
TRANSFER LEARNING. Journal for Advanced Research in Applied Sciences; Pages: 463-471

The brightness corrected color fundus images were then subjected to gamma correction on each red, green and blue(R,G,B) image. Hemorrhages
candidates were detected using density analysis. The difference in the pixel values between two smoothened images detected the blood vessels
and hemorrhage candidates. The FPs blood vessels are eliminated using bounding box.

Classification

This comprises three steps:

1) Training stage: identifying training areas and developing a numerical description of the attributes of each class type through training set.
2) Classification stage: data set is categorized into the class it most closely resembles and
3) Output stage: the process consists of a matrix of interpreted category types. Accuracy assessment of the classified output revealed that normal
cases were classified with 90% accuracy while moderate and severe NPDR cases were 87.5% accurate.

6] Giraddi , detection of the exudates in the color variability and contrast retinal images. Comparative analysis made for SVM and KNN
classifier for earliest detection. They utilized the GLCM texture features extraction for obtaining the reduced number of false positives
.Eventually the true positive rates for SVM classifier around 83.4 and KNN classifier around 92%.

IV. METHODOLOGY
Overview

Deep learning uses neural networks to learn useful representations of features directly from data. If you have labeled data, perform supervised
learning with convolutional neural networks (CNNs, ConvNets) for classification, regression, and transfer learning using retrained networks. We
begin by trying to solve the 5-class classification task on our noisy dataset. We denoise, normalize, and augment the data as described in the
preprocessing section, and address the class imbalance problem by either over-sampling the minority classes or using cost-sensitive learning.
Next, we build three different models: a custom architecture built as a baseline where all layers are trained, a classifier built using a pretrained
AlexNet [14] where only the last layer is retrained, and a GoogLeNet [18] constructed similarly to AlexNet. All weights that werent loaded via
transfer learning were initialized using the Xavier initialization scheme. For all three of our models, the final prediction is made using a softmax
layer. Therefore, our loss function is defined as:

Where syi is the score for example is label, and s j is the score for a particular label j . The softmax contained in the log ensures that the prediction
probabilities are a proper probability distribution.

Baseline
As a baseline, we built a convolutional neural network from scratch that acts as our control. The model is trained using randomized
hyperparameter search. The architecture for our baseline is:

[Input - Conv ReLU Pool - FC]

The model was initialized using the Xavier initialization scheme, and updated using Adam. The model served the purpose of guiding our
research and the results motivated some of the decisions in our improved transfer learning models.

Convolution Network Architectures

In general, especially classification of diseases with the proposed architecture a DCNN[add citation] following these basic steps to achieve
maximum accuracy from the images dataset are i) Data Augmentation ii) Pre-processing iii)Initialization of Networks iv) training v) Activation
function selections vi) Regularizations vii) Ensemble the multiple methods.

A.DATA AUGMENTATION

The funds images are obtained from the different datasets are taken under different camera with varying field of view, non-clarity, blurring,
contrast and sizes of images different. In data augmentation, contrast adjustment, flipping images, brightness adjustments are made.

B.PREPROCESSING

For Deep convolution neural network worked on spatial data of the fundus images. A primary steps involved in the preprocessing is resizing the
images. Before feeding into the architecture for classification, convert the images in to gray scale. And then, convert in to the L model. It is a
monochrome images which is used to highlights the microaneurysms, and vessels in the fundus images. And flatten the images in single
dimensional for processing further.

C. CNN CLASSIFICATION

In Image recognition, a Convolutional Neural Network (CNN) is a type of feed-forward artificial neural network in which the connectivity
pattern between its neurons is inspired by the organization of animal visual cortex, whose individual neurons are arranged in such a way that
responds to overlapping regions tiling the visual field. In deep learning, the convolutional neural network uses a complex architecture composed
of stacked layers in which is particularly well-adapted to classify the images. For multi-class classification, this architecture robust and sensitive
to each feature present in the images.
468. Lakshmi Govind and Dharmendra Kumar,. DIABETIC RETINOPATHY DETECTION USING
TRANSFER LEARNING. Journal for Advanced Research in Applied Sciences; Pages: 463-471

Common layers deployed in making Deep Convolutional Neural Network architecture (DCNN) are

1. Convolution Layer
2. Pooling Layer
3. ReLU Layer
4. Fully connected Layer
5. Classification Layer

1) CONVOLUTIONAL LAYER:

This is the first and foremost layer laid after the input image which wants to be classified. The backbone of the convolutional neural network is:
local receptive fields, shared weights. These are making deep convolutional neural network for image recognition.

Local receptive field:

During image recognition, convolutional neural network consists of multiple layers of small neuron collections which look at small portions of
the input image.

Shared weights and bias:

Each feature map of the convolutional neural network shared the same weights and bias values. This shared value will represent the same feature
all over the image. Depends on the application, the feature map generation is varied.
The convolutional layer consists of kernel or set of filters (local receptive field). Each filter is convolved against the input image and
extracts the features by forming a new layer or activation map. Each activation map contain or represent some significant characteristic or
features of the input image.

2) POOLING LAYER:
This is one of the most significant layers which helps the network from avoiding over-fitting by reduce the parameters and computation in the
network. It works as a form of non-linear down sampling.

Pooling partition the activation maps into set of rectangles and collect the maximum value in the sub region. Its merely a downsize the pixels
with features.

3) ReLU LAYER
Rectified Linear Unit (ReLU) layer is an activation function.

f(x) = max(0,x)

x input to the neuron; also a ramp function.

A smooth approximation to the rectifier is the analytic function.

f(x) = ln (1+ex)

This activation function induces the sparsity in the hidden units. Also, it has been shown that the deep neural networks can be trained efficiently
compared to sigmoid and logistic regression activation function.

4) FULLY CONNECTED LAYER:

The layer which comes after the cascaded convolutional and max/average pooling layer is called fully connected layer. The high level reasoning
is done through this layer during classification.

A fully connected layer takes all neurons in the previous layer from max-pooling layer and connects it to every neuron it has. Fully connected
layers are not spatially connected anymore. It visualize as one-dimensional layer.

5) CLASSIFICATION LAYER:

After the stacked or deep multiple layers, the final layer is a softmax layer which stacked at the end for classifying the fundus image followed by
the fully connected layer output. Here, the deciding as a single-class classification or multiclass classification.

TRANSFER LEARNING

If you have a small amount of training data, constructing and training a new network can be time consuming and ineffective. Instead, you can
fine-tune an existing pretrained network to solve a new problem. This technique, called transfer learning, usually results in faster training. By
taking layers from a pretrained network and retraining the layers only at the end of the network, you can finish training much faster. Few of the
pretrained are explained below:

AlexNet
The first pretrained model we use was AlexNet. AlexNet, developed in part by Alex Krizhevsky in 2012, is one of the best CNNs today, having
won the imagenet challenge. We utilized this model by loading the pretrained weights, and only retrain the final fully connected layer to predict
5 classes rather than 1000.
469. Lakshmi Govind and Dharmendra Kumar,. DIABETIC RETINOPATHY DETECTION USING
TRANSFER LEARNING. Journal for Advanced Research in Applied Sciences; Pages: 463-471

This usage of transfer learning is viable because many of the early layers of the network learn similar features, such as edges and lines. By
loading these pretrained weights, our model effectively already knows how to detect lines and edges, and need only learn how to use them to
make predictions for our problem. Below is an image that shows the basic architecture of Alexnet.

Inception

The pre-trained Inception model achieves state-of-the-art accuracy for recognizing general objects with 1000 classes, like "Zebra", "Dalmatian",
and "Dishwasher". The model extracts general features from input images in the first part and classifies them based on those features in the
second part. In transfer learning, when you build a new model to classify your original dataset, you reuse the feature extraction part and re-train
the classification part with your dataset. Since you don't have to train the feature extraction part (which is the most complex part of the model),
you can train the model with less computational resources and training time.

The architecture of Inception is shown below:

VGGNet16

VGGNet has been developed by Simonyan and Zisserman. Its main contribution was in showing that the depth of the network is a critical
component for good performance. Their final best network contains 16 CONV/FC layers and features an homogeneous architecture that only
performs 3*3 convolutions and 2*2 pooling from the beginning to the end. The whole VGGNet is composed of CONV layers that perform 3*3
convolutions with stride 1 and pad 1 and of POOL layers that perform 2*2 max pooling with stride 2. It contains around 140 parameters.

MODEL KAPPA ACCURACY SENSITIVITY SPECIFICITY

2layer(conv+dense) 0.12 58% 80% 48%
0.18 62% 81% 52%
4 layer (2conv +2dense)
0.18 63% 80% ` 56%
6 layer(2(Conv + maxpool) + 2 dense
AlexNet + Logistic Regression 0.29 68% 84% 59%

VGG+ Logistic Regression 0.28 71% 85% 63%

Inception +Logistic Regression 0.34 74% 86% 69%

Fine tuning last 5 layers AlexNet

0.41 83% 90% 73%
Fine-tuning AlexNet: The AlexNet network we use here for DR screening was initially trained on ImageNet. The ImageNet dataset contains
about 1 million natural images and 1000 labels/categories. In contrast, our labeled DR Dataset has only about 30,000 domain-specific images
and 4 labels/ categories.
470. Lakshmi Govind and Dharmendra Kumar,. DIABETIC RETINOPATHY DETECTION USING
TRANSFER LEARNING. Journal for Advanced Research in Applied Sciences; Pages: 463-471

Thus, the DR Dataset is insufficient to train a network as complex as AlexNet and so we use weights from the ImageNet-trained AlexNet
network. We fine-tune the last 5 pre-trained layers which contains more generic data-independent weights. The original classification layer
outputs predictions for 1000 classes. We replace it with a new five classes layer.

V. RESULTS
Accuracy, Kappa, Specificity and Sensitivity are the crucial parameters for deciding the effectiveness of the algorithm. We have done test on
dataset with trying different parameters for classification. These are the basic parameters that we had supplied in order to run our test. Here is a
quick explanation of what each of these parameters mean:

hidden units: This represents the number of nodes in the hidden layer
Learning rate: This variable determinates the learning rate for the neural network. A smaller learning rate makes the system learn in finer
increments, but can also drastically increase the time required to train the system.
Batch size: This is the batch size for the training example.
Layer size: number of layers implemented.
Max iterations: This determines the maximum amount of times to iterate overall.

The below table shows the accuracies given by different models with different parameters. This graph indicates the validation and train
performance curve to the number of epochs for Alexnet with fine tuning.

P
e
r
f
o
r
m
a
n
c
e

Epochs

P
e
r
f
o
r
m
a
n
c
e

Epochs
471. Lakshmi Govind and Dharmendra Kumar,. DIABETIC RETINOPATHY DETECTION USING
TRANSFER LEARNING. Journal for Advanced Research in Applied Sciences; Pages: 463-471

VI. CONCLUSION
In this paper, we proposed a method for detection of Diabetic Retinopathy based on Transfer Learning. Several model with different algorithms
are applied to get better classification. Pretrained networks like AlexNet, VGGNet and Incpetion were used to increase its accuracy. We plan to
finetune the Alexnet for improving Computational time for training and accuracy.

REFERENCES
[1] S.Wang, Hierarchical retinal blood vessel segmentation based on feature and ensemble learning.

[2] Mrinal Haloi, Improved Microaneurysm detection using Deep Neural Networks.

[3] T Chandrakumar, Classifying Diabetic Retinopathy using Deep Learning Architecture.

[4] Kanika Verma, Prakash Deep, and A. G. Ramakrishnan, Detection and Classification of Diabetic Retinopathy using Retinal Images.

[5] Kiran R. Latare, A Novel Approach for the detection and classification of Diabetic Retinopathy.

[6] Manjiri B. Patwari, Ramesh R. Manza, Yogesh M. Rajput, Review on Detection and Classification of Diabetic Retinopathy Lesions Using
Image Processing Techniques.

[7] N.R.Brindha, An Approach of Dictionary Generation for Diabetic Retinopathy Detection.

[8] Hary Pratt, Frans Coenen, Deborah M Bradbent, Convolutional Neural Networks for Diabetic Retinopathy.

[9] Mohit Singh Solanki, Diabetic Retinopathy Detection using Eye Images.