Two Eyes Are Better Than One: Exploiting Binocular Correlation for Diabetic Retinopathy Severity Grading

Diabetic retinopathy (DR) is one of the most common eye conditions among diabetic patients. However, vision loss occurs primarily in the late stages of DR, and the symptoms of visual impairment, ranging from mild to severe, can vary greatly, adding to the burden of diagnosis and treatment in clinical practice. Deep learning methods based on retinal images have achieved remarkable success in automatic DR grading, but most of them neglect that the presence of diabetes usually affects both eyes, and ophthalmologists usually compare both eyes concurrently for DR diagnosis, leaving correlations between left and right eyes unexploited. In this study, simulating the diagnostic process, we propose a two-stream binocular network to capture the subtle correlations between left and right eyes, in which, paired images of eyes are fed into two identical subnetworks separately during training. We design a contrastive grading loss to learn binocular correlation for five-class DR detection, which maximizes inter-class dissimilarity while minimizing the intra-class difference. Experimental results on the EyePACS dataset show the superiority of the proposed binocular model, outperforming monocular methods by a large margin.Clinical relevance— Compared to conventional DR grading methods based on monocular images, our approach can provide more accurate predictions and extract graphical patterns from retinal images of both eyes for clinical reference.