Explainable Diabetic Retinopathy Classification Using Vision Foundation Models
Abhishek VermaAnila KrishnaAbhishek Gajanan BankarJuan Miguel Lopez Alcaraz
Aug 2026
Machine LearningComputer Vision
Abstract
Diabetic retinopathy (DR) is a major cause of preventable blindness, creating a need for accurate and trustworthy automated screening. This study investigates an explainable DR classification framework using vision foundation models and multiple transfer learning strategies. Three backbones, DINOv2, CLIP, and Vision Transformer (ViT), were evaluated using full fine-tuning, linear probing, and Low-Rank Adaptation (LoRA). Models were trained and internally evaluated on the ODIR dataset and externally evaluated on APTOS to assess generalization. DINOv2-LoRA achieved the highest internal AUROC of 0.758, while DINOv2 full fine-tuning and ViT full fine-tuning achieved the highest external AUROC of 0.920. Calibration was further assessed using reliability analysis after isotonic regression. For explainability, Grad-CAM and HiResCAM were evaluated against expert-annotated lesion masks from the IDRiD dataset using Dice, Intersection over Union (IoU), and Pointing Game metrics. The results demonstrate that foundation models, particularly DINOv2, can provide strong predictive performance, while LoRA offers a parameter-efficient alternative to full fine-tuning. Quantitative evaluation of explanation maps further supports the assessment of whether model attention corresponds to clinically relevant retinal lesions.
This article investigates several physics-informed and hybrid machine learning strategies that incorporate physics knowledge in experimental data-driven deep-learning models for predicting the bond quality and porosity of fused filament fabrication (FFF) parts. Three types of strategies are explored to incorporate physics constraints and multi-physics FFF simulation results into a deep neural network (DNN), thus ensuring consistency with physical laws: (1) incorporate physics constraints within the loss function of the DNN, (2) use physics model outputs as additional inputs to the DNN model, and (3) pre-train a DNN model with physics model input-output and then update it with experimental data. These strategies help to enforce a physically consistent relationship between bond quality and tensile strength, thus making porosity predictions physically meaningful. Eight different combinations of the above strategies are investigated. The results show how the combination of multiple strategies produces accurate machine learning models even with limited experimental data.
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