# Cross-Modal Semantic-Enhanced Diffusion Framework for Diabetic Retinopathy Grading

arXiv: https://arxiv.org/abs/2605.09242 · HTML: https://mlsanity.com/paper/2605.09242/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical vision-language models, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 12 of its 17 references that are in the map.
- First posted on arXiv 10 May 2026.

## Placed in

- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 12 of 12)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Learning Imbalanced Datasets with Label-Distribution-Aware Margin Loss](https://mlsanity.com/paper/1906.07413/) (2019)
- [Training Region-based Object Detectors with Online Hard Example Mining](https://mlsanity.com/paper/1604.03540/) (2016)
- [MedCLIP: Contrastive Learning from Unpaired Medical Images and Text](https://mlsanity.com/paper/2210.10163/) (2022)
- [BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairs](https://mlsanity.com/paper/2303.00915/) (2023)
- [DiffMIC: Dual-Guidance Diffusion Network for Medical Image Classification](https://mlsanity.com/paper/2303.10610/) (2023)
- [RET-CLIP: A Retinal Image Foundation Model Pre-trained with Clinical Diagnostic Reports](https://mlsanity.com/paper/2405.14137/) (2024)
- [ProCo: Prototype-aware Contrastive Learning for Long-tailed Medical Image Classification](https://mlsanity.com/paper/2209.00183/) (2022)
- [CLIP-DR: Textual Knowledge-Guided Diabetic Retinopathy Grading with Ranking-aware Prompting](https://mlsanity.com/paper/2407.04068/) (2024)
- [Distractor-Aware Neuron Intrinsic Learning for Generic 2D Medical Image Classifications](https://mlsanity.com/paper/2007.09979/) (2020)
- [A Deep Multi-task Learning Approach to Skin Lesion Classification](https://mlsanity.com/paper/1812.03527/) (2018)

## Abstract (arXiv)

Automated grading of diabetic retinopathy (DR) faces several critical challenges: subtle inter-grade visual distinctions in fine-grained lesion patterns, distributional discrepancies induced by heterogeneous imaging devices and acquisition conditions, and the inherent inability of purely visual approaches to exploit clinical semantic knowledge. In this paper, we propose CLIP-Guided Semantic Diffusion (CGSD), a DR grading framework that synergistically integrates vision-language pretraining with diffusion probabilistic modeling. We adopt a domain-specific vision-language model tailored for DR grading as the semantic guidance module and adapt it to the target domain via Low-Rank Adaptation (LoRA), effectively bridging the distributional gap between the pretrained model and the target dataset with only a minimal number of trainable parameters. Building on this foundation, we construct a cross-modal semantic conditioning vector by computing the dot product between image features and the text description features of each DR grade, yielding a joint representation that simultaneously encodes visual content and clinical-grade semantics. This vector serves as the conditioning signal for the diffusion denoising network, replacing the structurally complex dual-branch visual prior employed in existing diffusion-based classification methods. Experiments on the APTOS 2019 dataset demonstrate that the proposed approach achieves an accuracy of 87.5% and a macro-averaged F1 score of 0.731, outperforming a variety of representative methods. Ablation studies further validate the independent contribution of each constituent module.