# Contrastive learning-based pretraining improves representation and transferability of diabetic retinopathy classification models

arXiv: https://arxiv.org/abs/2208.11563 · HTML: https://mlsanity.com/paper/2208.11563/

## Key facts

- Cited by 5 papers in the map (data through 14 Oct 2026).
- Builds on 14 of its 43 references that are in the map.
- First posted on arXiv 24 Aug 2022.

## Builds on (most cited first, 14 of 14)

- [A Simple Framework for Contrastive Learning of Visual Representations](https://mlsanity.com/paper/2002.05709/) (2020)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [Arbitrary Style Transfer in Real-time with Adaptive Instance Normalization](https://mlsanity.com/paper/1703.06868/) (2017)
- [ImageNet-trained CNNs are biased towards texture; increasing shape bias improves accuracy and robustness](https://mlsanity.com/paper/1811.12231/) (2018)
- [Unsupervised Learning of Visual Representations by Solving Jigsaw Puzzles](https://mlsanity.com/paper/1603.09246/) (2016)
- [Large Batch Training of Convolutional Networks](https://mlsanity.com/paper/1708.03888/) (2017)
- [Transfusion: Understanding Transfer Learning for Medical Imaging](https://mlsanity.com/paper/1902.07208/) (2019)
- [Big Self-Supervised Models Advance Medical Image Classification](https://mlsanity.com/paper/2101.05224/) (2021)
- [Style Augmentation: Data Augmentation via Style Randomization](https://mlsanity.com/paper/1809.05375/) (2018)
- [MoCo-CXR: MoCo Pretraining Improves Representation and Transferability of Chest X-ray Models](https://mlsanity.com/paper/2010.05352/) (2020)
- [Learning domain-agnostic visual representation for computational pathology using medically-irrelevant style transfer augmentation](https://mlsanity.com/paper/2102.01678/) (2021)
- [Lesion-based Contrastive Learning for Diabetic Retinopathy Grading from Fundus Images](https://mlsanity.com/paper/2107.08274/) (2021)
- [Deep Learning based Computer-Aided Diagnosis Systems for Diabetic Retinopathy: A Survey](https://mlsanity.com/paper/1811.01238/) (2018)
- [Transfer Learning for Automated OCTA Detection of Diabetic Retinopathy](https://mlsanity.com/paper/1910.01796/) (2019)

## Built on by (most cited first, 5 of 5)

- [Foundation Models in Medical Imaging: A Review and Outlook](https://mlsanity.com/paper/2506.09095/) (2025)
- [PoCo: A Self-Supervised Approach via Polar Transformation Based Progressive Contrastive Learning for Ophthalmic Disease Diagnosis](https://mlsanity.com/paper/2403.19124/) (2024)
- [Local-to-Global Self-Supervised Representation Learning for Diabetic Retinopathy Grading](https://mlsanity.com/paper/2410.00779/) (2024)
- [From Retinal Pixels to Patients: Evolution of Deep Learning Research in Diabetic Retinopathy Screening](https://mlsanity.com/paper/2511.11065/) (2025)
- [A Cascaded Edge-Cloud Architecture for Automated Diabetic Retinopathy Screening](https://mlsanity.com/paper/2605.14108/) (2026)

## Abstract (arXiv)

Self supervised contrastive learning based pretraining allows development of robust and generalized deep learning models with small, labeled datasets, reducing the burden of label generation. This paper aims to evaluate the effect of CL based pretraining on the performance of referrable vs non referrable diabetic retinopathy (DR) classification. We have developed a CL based framework with neural style transfer (NST) augmentation to produce models with better representations and initializations for the detection of DR in color fundus images. We compare our CL pretrained model performance with two state of the art baseline models pretrained with Imagenet weights. We further investigate the model performance with reduced labeled training data (down to 10 percent) to test the robustness of the model when trained with small, labeled datasets. The model is trained and validated on the EyePACS dataset and tested independently on clinical data from the University of Illinois, Chicago (UIC). Compared to baseline models, our CL pretrained FundusNet model had higher AUC (CI) values (0.91 (0.898 to 0.930) vs 0.80 (0.783 to 0.820) and 0.83 (0.801 to 0.853) on UIC data). At 10 percent labeled training data, the FundusNet AUC was 0.81 (0.78 to 0.84) vs 0.58 (0.56 to 0.64) and 0.63 (0.60 to 0.66) in baseline models, when tested on the UIC dataset. CL based pretraining with NST significantly improves DL classification performance, helps the model generalize well (transferable from EyePACS to UIC data), and allows training with small, annotated datasets, therefore reducing ground truth annotation burden of the clinicians.