Triple-Stream Deep Feature Selection with Metaheuristic Optimization and Machine Learning for Multi-Stage Hypertensive Retinopathy Diagnosis

Hypertensive retinopathy (HR) is a severe eye disease that may cause permanent vision loss if not diagnosed early. Traditional diagnostic methods are time-consuming and subjective, highlighting the need for an automated, reliable system. Existing studies often use a single Deep Learning (DL) model, struggling to distinguish HR stages. This study introduces a three-stage approach to enhance HR diagnosis accuracy. Initially, 14 CNN models were tested, identifying DenseNet169, MobileNet, and ResNet152 as the most effective. DenseNet169 achieved 87.73% accuracy, 87.75% precision, 87.73% recall, 87.67% F1-score, and 0.8359 Cohen's Kappa. MobileNet followed with 86.40% accuracy, 86.60% precision, 86.40% recall, 86.31% F1-score, and 0.8180 Cohen's Kappa. ResNet152 ranked third with 85.87% accuracy, 86.01% precision, 85.87% recall, 85.83% F1-score, and 0.8188 Cohen's Kappa. In the second stage, deep features from these models were fused and classified using Machine Learning (ML) algorithms (SVM, RF, XGBoost). SVM (sigmoid kernel) performed best with 92.00% accuracy, 91.93% precision, 92.00% recall, 91.91% F1-score, and 0.8930 Cohen's Kappa. The third stage applied meta-heuristic optimization (GA, ABC, PSO, HHO) for feature selection. HHO yielded 94.66% accuracy, precision, and recall, 94.64% F1-score, and 0.9286 Cohen's Kappa. The proposed approach surpassed single CNN models and previous studies in HR diagnosis accuracy and generalization.