DcardNet: Diabetic Retinopathy Classification at Multiple Levels Based on Structural and Angiographic Optical Coherence Tomography

Pengxiao Zang, Liqin Gao, Tristan T. Hormel, Jie Wang, Qisheng You, Thomas S. Hwang, Yali Jia

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Objective: Optical coherence tomography (OCT) and its angiography (OCTA) have several advantages for the early detection and diagnosis of diabetic retinopathy (DR). However, automated, complete DR classification frameworks based on both OCT and OCTA data have not been proposed. In this study, a convolutional neural network (CNN) based method is proposed to fulfill a DR classification framework using en face OCT and OCTA. Methods: A densely and continuously connected neural network with adaptive rate dropout (DcardNet) is designed for the DR classification. In addition, adaptive label smoothing was proposed and used to suppress overfitting. Three separate classification levels are generated for each case based on the International Clinical Diabetic Retinopathy scale. At the highest level the network classifies scans as referable or non-referable for DR. The second level classifies the eye as non-DR, non-proliferative DR (NPDR), or proliferative DR (PDR). The last level classifies the case as no DR, mild and moderate NPDR, severe NPDR, and PDR. Results: We used 10-fold cross-validation with 10% of the data to assess the network's performance. The overall classification accuracies of the three levels were 95.7%, 85.0%, and 71.0% respectively. Conclusion/Significance: A reliable, sensitive and specific automated classification framework for referral to an ophthalmologist can be a key technology for reducing vision loss related to DR.

Original languageEnglish (US)
Article number9207828
Pages (from-to)1859-1870
Number of pages12
JournalIEEE Transactions on Biomedical Engineering
Issue number6
StatePublished - Jun 2021
Externally publishedYes


  • Eye
  • image classification
  • neural networks
  • optical coherence tomography

ASJC Scopus subject areas

  • Biomedical Engineering


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