2016 2nd International Conference on Next Generation Computing Technologies (NGCT-2016)
Dehradun, India 14-16 October 2016
Diagnosis of Diabetic Retinopathy Using Machine
Learning Classification Algorithm
Karan Bhatia Shikhar Arora
University of Petroleum and Energy University of Petroleum and Energy
Studies, Dehradun, India Studies, Dehradun, India
karan_bhatia98@yahoo.com hi.shikhararora@gmail.com
Abstract— Diabetic Retinopathy is human eye disease
which causes damage to retina of eye and it may eventually
lead to complete blindness. Detection of diabetic
retinopathy in early stage is essential to avoid complete
blindness. Many physical tests like visual acuity test, pupil
dilation, optical coherence tomography can be used to
detect diabetic retinopathy but are time consuming and
affects patients as well. This review paper focuses on
decision about the presence of disease by applying
ensemble of machine learning classifying algorithms on
features extracted from output of different retinal image
processing algorithms, like diameter of optic disk, lesion
specific (microaneurysms, exudates), image level (pre-
screening, AM/FM, quality assessment). Decision making
for predicting the presence of diabetic retinopathy was
performed using alternating decision tree, adaBoost, Naïve
Bayes, Random Forest and SVM.
Keywords— Diabetic retinopathy, machine learning,
ensemble learning, exudate, decision tree, adaBoost, Naïve
Bayes, Random Forest, SVM
I. INTRODUCTION
Diabetic retinopathy or diabetic eye disease is caused by
diabetes mellitus which manifests itself in the eye retina.
Diabetic eye disease is one of the most frequent causes of
complete blindness in many developed countries. The
detection of retinal pathologies became much easier using
automated retinal image analysis whereas other methods like
dilation of eye pupil is time consuming and patient has to
suffer for some time. Diabetic retinopathy occurs when high
blood glucose damages the small vessels that provides
nutrients and oxygen to the retina. This paper focuses on
automated computer-aided detection of diabetic retinopathy
(DR) using features drawn from output of different retinal
image processing algorithms, like diameter of optic disk,
lesion specific (microaneurysms, exudates), image level (pre-
screening, AM/FM, quality assessment). These features are
then used in an ensemble machine learning system comprising
of different learning algorithms like alternating decision tree,
adaBoost, Naïve Bayes, Random Forest and SVM.[1] The
characteristic features extracted by anatomical part recognition
algorithms and lesion detection are used to classify images. An
978-1-5090-3257-0/16/$31.00 ©2016 IEEE
Ravi Tomar
University of Petroleum and Energy
Studies, Dehradun, India
ravitomar7@gmail.com
ensemble of classifiers then uses these features to classify the
whether an image has diabetic retinopathy or not. The most
important features are the exudates which provide information
about diabetic retinopathy in early stages. The major cause of
exudates is the leakage of protein and lipids into the retina
through damaged blood vessels. So, an ensemble based
machine learning techniques are used to detect presence of
diabetic retinopathy in an image.
II. LITERATURE REVIEW
Bálint Antal and András Hajdu proposed a method for an
automatic system for diabetic retinopathy screening[1]. The
method comprised of two components: feature extraction from
images and ensemble learning system.
1. Feature Extraction
The feature extraction comprised of three different
parts depending upon the features to be extracted.
1.1. Image level components
1.1.1. Quality Assessment
The images were classified whether they had sufficient
quality for a reliable decision with supervised classifier,
whether the box count values of the detected vessel system
serve as features. An approach based on Hidden Markov
Random Fields (HMRF) was used for vessel segmentation.
1.1.1.1. Pre-screening
In pre-screening test, the images were classified as
having severely diseased (abnormal) or to be forwarded for
further processing. A simple texture descriptor is extracted
from the disjoint regions from each image. Then, a classifier
algorithm is trained to classify the images based on these
features.
1.1.1.2. Multi-scale AM/FM based feature extraction
Information from image is extracted from Amplitude-
Modulation Frequency-Modulation (AM/FM) method. The
green channels of the images are decomposed into different
representations which reflect the intensity, geometry and
texture of the structure with signal processing techniques like
Amplitude-Modulation and Frequency-Modulation. The 39
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2016 2nd International Conference on Next Generation Computing Technologies (NGCT-2016)
Dehradun, India 14-16 October 2016
different representations of the image are established using the
extracted information
1.1.2. Lesion-specific components
1.1.2.1. Microaneurysm detection
Microaneurysm are one of the earliest symptoms of
diabetic retinopathy. They are the small red dots in the image
and their similarity to vessel fragments make it hard to detect
them efficiently.
1.1.2.2. Exudate detection
Exudates are the initial symptoms of diabetic
retinopathy and it occurs when fat leak or lipid from blood
vessels or aneurysms. Exudates are small bright red spots of
irregular shapes.
1.1.3. Anatomical components
1.1.3.1. Macula detection
The central region of sharp vision in the human eye is
called Macula, with its center referred to as the fovea. Lesions
within the macula can lead to loss of vision. The macula is
located in the center of retina, temporal to optic nerve. The
location of the macula along with the optic disc described
below.
1.1.3.2. Optic disc detection
It is a circular shaped anatomical structure having a
bright appearance. Optic disc is the area where the optic nerve
enters the eye. The correct detection of center and radius of
optic disc can be used for locating another anatomical parts
like macula. Recognizing anatomical parts are essential in two
ways: at particular positions the appearance of specific lesions
indicate stages of DR; and detection of optic disk and macula
can be ruined by the presence of rare but serious defects like
retinal detachment.
Fig 1. Differnce between detected and actual
centers of macula and optic disk [1]
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2. Ensemble learning
This part focuses on designing a computer-aided
medical system which is highly reliable. The features
extracted in the first part are used here to train different
classifiers to separate DR and non-DR cases and the results of
all classifiers are fused together
2.1. Concepts of ensemble learning
Ensemble learning is the technique of training
different classifiers and selecting the subset of these classifiers
to detect DR cases. Two algorithms have been used by the
authors[1] to select the best ensemble system: first one is the
forward search method in which first the best individual
classifier is selected. Then, if the performance of the ensemble
increases, further classifiers are added. When there is no
further increase of performance is reached by adding more
classifiers then the process ends. The second method is the
backward search in which first, the classifiers are considered
as the members of ensemble. Then, classifiers are removed
from the ensemble while the performance of the ensemble
increases.
3. Dataset used
The dataset used by the authors is a publicly available
Messidor database which consists of 1200 losslessly
compressed images with 450 FOV and different resolutions.[2]
Grading score ranging from R0 to R3 is provided from each
image.
3.1. Features
This section describes the features that were extracted
from the output of image processing algorithms presented in
section 1.
0) The result of quality assessment. 0(bad quality) and
1(sufficient quality).
1) The pre-screening result, where 1 means severe retinal
abnormality and 0 its absence.
2-7) Results of MA detection. Each feature value calculates
the number of MAs found at the confidence levels alpha =
0.5, . . . , 1, respectively.
8-15) contains same information as 2-7) for exudates. As
exudates are represented by a set of points constructing
the lesions, these features normalized by dividing no. of
lesions with the diameter of the ROI to compensate
different image sizes.
16) Euclidean distance of macula center and the optic disc
center to provide important information regarding the
patient’s condition. This feature is also normalized with
the diameter of the ROI.
17) Optic disc diameter.
18) Result of the AM/FM-based classification (0,1).
19) Class label. 1 means DR case (Accumulative label for the
Messidor classes 1, 2, 3), 0 means non DR.
2016 2nd International Conference on Next Generation Computing Technologies (NGCT-2016)
Dehradun, India 14-16 October 2016

4.Classifiers and Energy functions used

The following classifiers have been used as potential
members of ensemble.

x Alternating Decision Tree

x kNN
x AdaBoost
x Naïve Bayes
x Random Forest
x SVM
x Pattern Classifier
Fig 3. Results of backward search algorithm
For ensemble selection, following energy functions are used:
III. PROPOSED WORK
In this paper, we are proposing a method in which we
x Senstivity = train individual classifier algorithm and not the ensemble of
that. The features extracted in the paper by Bálint Antal and
András Hajdu will be used to train the classifiers and the best
individual classifiers are used to identify DR or non-DR
categories[1]. The classifiers that will be trained are as
x Accuracy = followed :

x Logistic Regression
Logistic Regression is the statistical regression model in which
x F-score = the output variable is categorical and not continuous valued.
The output variable is categorical which may represent n
different classes. For multi class classification, one v/s all
where TP, FP, TN, FN represent the true and false positive and algorithm is used. The dataset we use have 2 classes i.e. DR
true and false negative classifications of the system, and non-DR cases.
respectively. In logistic regression the features are out into the trained
hypothesis and the outcome is the probability whether the
5. Results example belongs to category 0 or 1. The sigmoid function
The results for both forward search and backward whose value ranging between 0 and 1.
search method used by the authors[1] are shown in the tables
below.

g(z) =

Fig 2. Results of forward search algorithm

Fig 4. Graphical Representation of Sigmoid Function

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2016 2nd International Conference on Next Generation Computing Technologies (NGCT-2016)
Dehradun, India 14-16 October 2016

hΘ(x) =
ΘTX = Θ0 + Θ1X1 + Θ2X2 +…… + ΘnXn
where Θi’s are the parameters and n is the numbers of features
in the training set.
In fig. 4, graphical representation of Sigmoid function g(z) is
shown. It crosses y = 0.5 at origin and then flattens out and
also asymptotes at 0 and 1. So the value of Sigmoid function is
between 0 and 1, excluding 0 and 1.
x SVM
Support Vector Machines are the classification algorithms that
are used to classify the examples when the number of features
are very large. Sometimes, SVM gives better non-linear
hypothesis than the logistic regression and the neural
networks. SVMs are also referred to as large margin
classifiers.
In fig. 6, graph represents large margin classification in SVM.

The sigmoid logistic regression gives the probability of

whether the example belongs to category 0 or 1.

So, P(y=0) + P(y=1) = 1

x Neural Network
Neural Network are the learning algorithm that mimic human
brain. They are the classification algorithm that can classify an
example into multiple classes. A multi-layer neural network
will be used where the first layer is the input layer and the last
layer is output layer and the other layers are known as the
hidden layers. Each layer has units known as the artificial
neurons and the sigmoid activation function is used to activate
units. In between any two layers a parameter matrix is used
which does function mapping from previous layer to next Fig. 6. An example of SVM
layer. Forward propagation and backward propagation are
used to train the neural network.
IV. CONCLUSION
As in the dataset, we only have binary classification so the This paper proposed methods to develop an automated
output layer has only two units which gives the probability of system to detect the case of diabetic retinopathy among the
being 0 and 1. diabetic patients and is aimed at helping ophthalmologists to
detect early symptoms of diabetic retinopathy with ease. The
In fig. 5, an example of simple neural network is shown with 3 ideas proposed for the intelligent system can be understood by
units of input layer, 4 units of output layer and hidden layer this paper. Also this paper highlights various technologies used
having 5 units each. for diagnosis and detection of diabetic eye disease.

REFERENCES
[1] Bálint Antal, András Hajdu, “An ensemble-based system
for automatic screening of diabetic retinopathy”, Elsevier,
Volume 60, April 2014, Pages 20-27
[2] Deepa Patil, Bharti Patil, “An Ensemble based System for
Detection of Retinal Microaneurysms and Diabetic
Retinopathy”, International Journal of Electronics
Communication and Computer Engineering Volume 5,
Issue (4) July, Technovision-2014, pp-214-218 ISSN
2249–071X
[3] Shraddha Jalan, A. A. Tayade, “Review paper on Diagnosis of
Diabetic Retinopathy using KNN and SVM Algorithms”,
Fig 5. An example of Neural Network International Journal of Advance Research in Computer
Science and Management Studies

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2016 2nd International Conference on Next Generation Computing Technologies (NGCT-2016)
Dehradun, India 14-16 October 2016

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7782. Diabetic Retinopathy Images” ,International Journal of
[4] Mahendran Gandhi and Dr. R. Dhanasekaran, “Diagnosis Computer Applications® (IJCA) (0975–8887)
of Diabetic Retinopathy Using Morphological Process Proceedings on Emerging Trends in Electronics and
and SVM Classifier”, International conference on Telecommunication Engineering (NCET 2013).
Communication and Signal Processing, April 3-5, 2013.

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