Diabetic Retinopathy (DR) remains a leading cause of preventable blindness, with early detection critical for reducing vision loss worldwide. Over the past decade, deep learning has transformed DR screening, progressing from early convolutional neural networks trained on private datasets to advanced pipelines addressing class imbalance, label scarcity, domain shift, and interpretability. This survey provides the first systematic synthesis of DR research spanning 2016-2025, consolidating results from 50+ studies and over 20 datasets. We critically examine methodological advances, including self- and semi-supervised learning, domain generalization, federated training, and hybrid neuro-symbolic models, alongside evaluation protocols, reporting standards, and reproducibility challenges. Benchmark tables contextualize performance across datasets, while discussion highlights open gaps in multi-center validation and clinical trust. By linking technical progress with translational barriers, this work outlines a practical agenda for reproducible, privacy-preserving, and clinically deployable DR AI. Beyond DR, many of the surveyed innovations extend broadly to medical imaging at scale.

This paper encompasses an in-depth examination of Retinopathy of Prematurity (ROP) diagnosis, employing advanced deep learning methodologies. Our focus centers on refining and evaluating CNN-based approaches for precise and efficient ROP detection. We navigate the complexities of dataset curation, preprocessing strategies, and model architecture, aligning with research objectives encompassing model effectiveness, computational cost analysis, and time complexity assessment. Results underscore the supremacy of tailored CNN models over pre-trained counterparts, evident in heightened accuracy and F1-scores. Implementation of a voting system further enhances performance. Additionally, our study reveals the potential of the proposed customized CNN model to alleviate computational burdens associated with deep neural networks. Furthermore, we showcase the feasibility of deploying these models within dedicated software and hardware configurations, highlighting their utility as valuable diagnostic aids in clinical settings. In summary, our discourse significantly contributes to ROP diagnosis, unveiling the efficacy of deep learning models in enhancing diagnostic precision and efficiency.

Diabetic Retinopathy (DR), a vision-threatening complication of Dia-betes Mellitus (DM), is a major global concern, particularly in India, which has one of the highest diabetic populations. Prolonged hyperglycemia damages reti-nal microvasculature, leading to DR symptoms like microaneurysms, hemor-rhages, and fluid leakage, which, if undetected, cause irreversible vision loss. Therefore, early screening is crucial as DR is asymptomatic in its initial stages. Fundus imaging aids precise diagnosis by detecting subtle retinal lesions. This paper introduces a hybrid diagnostic framework combining traditional feature extraction and deep learning (DL) to enhance DR detection. While handcrafted features capture key clinical markers, DL automates hierarchical pattern recog-nition, improving early diagnosis. The model synergizes interpretable clinical data with learned features, surpassing standalone DL approaches that demon-strate superior classification and reduce false negatives. This multimodal AI-driven approach enables scalable, accurate DR screening, crucial for diabetes-burdened regions.

Diabetes mellitus is a major global health challenge, affecting over half a billion adults worldwide with prevalence projected to rise. Although the American Diabetes Association (ADA) provides clear diagnostic thresholds, early recognition remains difficult due to vague symptoms, borderline laboratory values, gestational complexity, and the demands of long-term monitoring. Advances in large language models (LLMs) offer opportunities to enhance decision support through structured, interpretable, and patient-friendly outputs. This study evaluates GPT-5, the latest generative pre-trained transformer, using a simulation framework built entirely on synthetic cases aligned with ADA Standards of Care 2025 and inspired by public datasets including NHANES, Pima Indians, EyePACS, and MIMIC-IV. Five representative scenarios were tested: symptom recognition, laboratory interpretation, gestational diabetes screening, remote monitoring, and multimodal complication detection. For each, GPT-5 classified cases, generated clinical rationales, produced patient explanations, and output structured JSON summaries. Results showed strong alignment with ADA-defined criteria, suggesting GPT-5 may function as a dual-purpose tool for clinicians and patients, while underscoring the importance of reproducible evaluation frameworks for responsibly assessing LLMs in healthcare.

The development of multi-label deep learning models for retinal disease classification is often hindered by the scarcity of large, expertly annotated clinical datasets due to patient privacy concerns and high costs. The recent release of SynFundus-1M, a high-fidelity synthetic dataset with over one million fundus images, presents a novel opportunity to overcome these barriers. To establish a foundational performance benchmark for this new resource, we developed an end-to-end deep learning pipeline, training six modern architectures (ConvNeXtV2, SwinV2, ViT, ResNet, EfficientNetV2, and the RETFound foundation model) to classify eleven retinal diseases using a 5-fold multi-label stratified cross-validation strategy. We further developed a meta-ensemble model by stacking the out-of-fold predictions with an XGBoost classifier. Our final ensemble model achieved the highest performance on the internal validation set, with a macro-average Area Under the Receiver Operating Characteristic Curve (AUC) of 0.9973. Critically, the models demonstrated strong generalization to three diverse, real-world clinical datasets, achieving an AUC of 0.7972 on a combined DR dataset, an AUC of 0.9126 on the AIROGS glaucoma dataset and a macro-AUC of 0.8800 on the multi-label RFMiD dataset. This work provides a robust baseline for future research on large-scale synthetic datasets and establishes that models trained exclusively on synthetic data can accurately classify multiple pathologies and generalize effectively to real clinical images, offering a viable pathway to accelerate the development of comprehensive AI systems in ophthalmology.

Diabetic retinopathy (DR) is a leading cause of vision loss worldwide, and early diagnosis through automated retinal image analysis can significantly reduce the risk of blindness. This paper presents a robust deep learning framework for both binary and five-class DR classification, leveraging transfer learning and extensive data augmentation to address the challenges of class imbalance and limited training data. We evaluate a range of pretrained convolutional neural network architectures, including variants of ResNet and EfficientNet, on the APTOS 2019 dataset. For binary classification, our proposed model achieves a state-of-the-art accuracy of 98.9%, with a precision of 98.6%, recall of 99.3%, F1-score of 98.9%, and an AUC of 99.4%. In the more challenging five-class severity classification task, our model obtains a competitive accuracy of 84.6% and an AUC of 94.1%, outperforming several existing approaches. Our findings also demonstrate that EfficientNet-B0 and ResNet34 offer optimal trade-offs between accuracy and computational efficiency across both tasks. These results underscore the effectiveness of combining class-balanced augmentation with transfer learning for high-performance DR diagnosis. The proposed framework provides a scalable and accurate solution for DR screening, with potential for deployment in real-world clinical environments.

Automatic classification of Diabetic Retinopathy (DR) can assist ophthalmologists in devising personalized treatment plans, making it a critical component of clinical practice. However, imbalanced data distribution in the dataset becomes a bottleneck in the generalization of deep learning models trained for DR classification. In this work, we combine global attention block (GAB) and category attention block (CAB) into the deep learning model, thus effectively overcoming the imbalanced data distribution problem in DR classification. Our proposed approach is based on an attention mechanism-based deep learning model that employs three pre-trained networks, namely, MobileNetV3-small, Efficientnet-b0, and DenseNet-169 as the backbone architecture. We evaluate the proposed method on two publicly available datasets of retinal fundoscopy images for DR. Experimental results show that on the APTOS dataset, the DenseNet-169 yielded 83.20% mean accuracy, followed by the MobileNetV3-small and EfficientNet-b0, which yielded 82% and 80% accuracies, respectively. On the EYEPACS dataset, the EfficientNet-b0 yielded a mean accuracy of 80%, while the DenseNet-169 and MobileNetV3-small yielded 75.43% and 76.68% accuracies, respectively. In addition, we also compute the F1-score of 82.0%, precision of 82.1%, sensitivity of 83.0%, specificity of 95.5%, and a kappa score of 88.2% for the experiments. Moreover, in our work, the MobileNetV3-small has 1.6 million parameters on the APTOS dataset and 0.90 million parameters on the EYEPACS dataset, which is comparatively less than other methods. The proposed approach achieves competitive performance that is at par with recently reported works on DR classification.

Despite the remarkable progress of large language models (LLMs) across various domains, their capacity to predict retinopathy of prematurity (ROP) risk remains largely unexplored. To address this gap, we introduce a novel Chinese benchmark dataset, termed CROP, comprising 993 admission records annotated with low, medium, and high-risk labels. To systematically examine the predictive capabilities and affective biases of LLMs in ROP risk stratification, we propose Affective-ROPTester, an automated evaluation framework incorporating three prompting strategies: Instruction-based, Chain-of-Thought (CoT), and In-Context Learning (ICL). The Instruction scheme assesses LLMs' intrinsic knowledge and associated biases, whereas the CoT and ICL schemes leverage external medical knowledge to enhance predictive accuracy. Crucially, we integrate emotional elements at the prompt level to investigate how different affective framings influence the model's ability to predict ROP and its bias patterns. Empirical results derived from the CROP dataset yield two principal observations. First, LLMs demonstrate limited efficacy in ROP risk prediction when operating solely on intrinsic knowledge, yet exhibit marked performance gains when augmented with structured external inputs. Second, affective biases are evident in the model outputs, with a consistent inclination toward overestimating medium- and high-risk cases. Third, compared to negative emotions, positive emotional framing contributes to mitigating predictive bias in model outputs. These findings highlight the critical role of affect-sensitive prompt engineering in enhancing diagnostic reliability and emphasize the utility of Affective-ROPTester as a framework for evaluating and mitigating affective bias in clinical language modeling systems.

Traditional Chinese medicine, as an essential component of traditional medicine, contains active ingredients that serve as a crucial source for modern drug development, holding immense therapeutic potential and development value. A multi-layered and complex network is formed from Chinese medicine to diseases and used to predict the potential associations between Chinese medicine ingredients and diseases. This study proposes an ingredient-disease association prediction model (Node2Vec-DGI-EL) based on hierarchical graph representation learning. First, the model uses the Node2Vec algorithm to extract node embedding vectors from the network as the initial features of the nodes. Next, the network nodes are deeply represented and learned using the DGI algorithm to enhance the model's expressive power. To improve prediction accuracy and robustness, an ensemble learning method is incorporated to achieve more accurate ingredient-disease association predictions. The effectiveness of the model is then evaluated through a series of theoretical verifications. The results demonstrated that the proposed model significantly outperformed existing methods, achieving an AUC of 0.9987 and an AUPR of 0.9545, thereby indicating superior predictive capability. Ablation experiments further revealed the contribution and importance of each module. Additionally, case studies explored potential associations, such as triptonide with hypertensive retinopathy and methyl ursolate with colorectal cancer. Molecular docking experiments validated these findings, showing the triptonide-PGR interaction and the methyl ursolate-NFE2L2 interaction can bind stable. In conclusion, the Node2Vec-DGI-EL model focuses on TCM datasets and effectively predicts ingredient-disease associations, overcoming the reliance on node semantic information.

Diabetic retinopathy (DR) is a leading cause of blindness worldwide, underscoring the importance of early detection for effective treatment. However, automated DR classification remains challenging due to variations in image quality, class imbalance, and pixel-level similarities that hinder model training. To address these issues, we propose a robust preprocessing pipeline incorporating image cropping, Contrast-Limited Adaptive Histogram Equalization (CLAHE), and targeted data augmentation to improve model generalization and resilience. Our approach leverages the Swin Transformer, which utilizes hierarchical token processing and shifted window attention to efficiently capture fine-grained features while maintaining linear computational complexity. We validate our method on the Aptos and IDRiD datasets for multi-class DR classification, achieving accuracy rates of 89.65% and 97.40%, respectively. These results demonstrate the effectiveness of our model, particularly in detecting early-stage DR, highlighting its potential for improving automated retinal screening in clinical settings.