# DRStageNet: Deep Learning for Diabetic Retinopathy Staging from Fundus Images

arXiv: https://arxiv.org/abs/2312.14891 · HTML: https://mlsanity.com/paper/2312.14891/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 14 of its 44 references that are in the map.
- First posted on arXiv 22 Dec 2023.

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

- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [Gaussian Error Linear Units (GELUs)](https://mlsanity.com/paper/1606.08415/) (2016)
- [EfficientNetV2: Smaller Models and Faster Training](https://mlsanity.com/paper/2104.00298/) (2021)
- [Quantifying Attention Flow in Transformers](https://mlsanity.com/paper/2005.00928/) (2020)
- [Self-supervised Feature Learning via Exploiting Multi-modal Data for Retinal Disease Diagnosis](https://mlsanity.com/paper/2007.11067/) (2020)
- [Grader variability and the importance of reference standards for evaluating machine learning models for diabetic retinopathy](https://mlsanity.com/paper/1710.01711/) (2017)
- [How Transferable Are Self-supervised Features in Medical Image Classification Tasks?](https://mlsanity.com/paper/2108.10048/) (2021)
- [Replication study: Development and validation of deep learning algorithm for detection of diabetic retinopathy in retinal fundus photographs](https://mlsanity.com/paper/1803.04337/) (2018)
- [Cross-Field Transformer for Diabetic Retinopathy Grading on Two-field Fundus Images](https://mlsanity.com/paper/2211.14552/) (2022)
- [An Interpretable Multiple-Instance Approach for the Detection of referable Diabetic Retinopathy from Fundus Images](https://mlsanity.com/paper/2103.01702/) (2021)

## Built on by (most cited first, 3 of 3)

- [Foundation Models in Medical Imaging: A Review and Outlook](https://mlsanity.com/paper/2506.09095/) (2025)
- [Prompt Mechanisms in Medical Imaging: A Comprehensive Survey](https://mlsanity.com/paper/2507.01055/) (2025)
- [Quasi-multimodal-based pathophysiological feature learning for retinal disease diagnosis](https://mlsanity.com/paper/2602.03622/) (2026)

## Abstract (arXiv)

Diabetic retinopathy (DR) is a prevalent complication of diabetes associated with a significant risk of vision loss. Timely identification is critical to curb vision impairment. Algorithms for DR staging from digital fundus images (DFIs) have been recently proposed. However, models often fail to generalize due to distribution shifts between the source domain on which the model was trained and the target domain where it is deployed. A common and particularly challenging shift is often encountered when the source- and target-domain supports do not fully overlap. In this research, we introduce DRStageNet, a deep learning model designed to mitigate this challenge. We used seven publicly available datasets, comprising a total of 93,534 DFIs that cover a variety of patient demographics, ethnicities, geographic origins and comorbidities. We fine-tune DINOv2, a pretrained model of self-supervised vision transformer, and implement a multi-source domain fine-tuning strategy to enhance generalization performance. We benchmark and demonstrate the superiority of our method to two state-of-the-art benchmarks, including a recently published foundation model. We adapted the grad-rollout method to our regression task in order to provide high-resolution explainability heatmaps. The error analysis showed that 59% of the main errors had incorrect reference labels. DRStageNet is accessible at URL [upon acceptance of the manuscript].