RDE-DR: robust deep ensemble CNNs for automated diabetic retinopathy detection from fundus images

Diabetic retinopathy (DR) is a leading cause of preventable blindness, motivating the development of reliable automated screening systems. This work proposes a Robust Deep Ensemble for Diabetic Retinopathy detection (RDE-DR) by analyzing ensemble fusion strategies. Four pre-trained convolutional neural networks (ResNet50, VGG16, VGG19, and DenseNet121) are trained using CLAHE-enhanced APTOS 2019 fundus images and integrated through seven heterogeneous fusion mechanisms, including voting-based, rank-based, and fuzzy-integral-inspired strategies. A consistent evaluation protocol is adopted, incorporating threshold optimization and probabilistic calibration analysis to validate robustness, decision margins, and accuracy-precision trade-offs. Experimental results show that multiple fusion techniques achieve comparable high performance and stable behavior on the APTOS 2019 benchmark, with the best configuration reaching 98.64% accuracy, 98.40% precision, 98.92% recall, 98.66% F1-score, and 99.78% Area-Under-Curve (AUC). Beyond peak accuracy, the study provides insights into ensemble reliability, calibration characteristics, and practical design choices for medical image classification systems. These results show that integrating transfer learning with CLAHE preprocessing and ensemble fusion yields stable experimental performance on the APTOS 2019 benchmark, suggesting potential for future medical decision support.

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Publication Details

Journal
Scientific Reports
Published
2026-05-17
DOI
https://doi.org/10.1038/s41598-026-48669-y
Primary Topic
Retinal Imaging and Analysis
Type
article
Field-Weighted Citation Impact
0.00

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article

RDE-DR: robust deep ensemble CNNs for automated diabetic retinopathy detection from fundus images

Oussama Bouguerra, Doaa Sami Khafaga, Bilal Attallah, Youcef Brik et al.
Scientific Reports
Retinal Imaging and Analysis
article

RDE-DR: robust deep ensemble CNNs for automated diabetic retinopathy detection from fundus images

Oussama Bouguerra, Doaa Sami Khafaga, Bilal Attallah, Youcef Brik, Ishaq Aiche, Abdelaziz Rabehi, El‐Sayed M. El‐kenawy, Mustapha Habib
article en

Abstract

Diabetic retinopathy (DR) is a leading cause of preventable blindness, motivating the development of reliable automated screening systems. This work proposes a Robust Deep Ensemble for Diabetic Retinopathy detection (RDE-DR) by analyzing ensemble fusion strategies. Four pre-trained convolutional neural networks (ResNet50, VGG16, VGG19, and DenseNet121) are trained using CLAHE-enhanced APTOS 2019 fundus images and integrated through seven heterogeneous fusion mechanisms, including voting-based, rank-based, and fuzzy-integral-inspired strategies. A consistent evaluation protocol is adopted, incorporating threshold optimization and probabilistic calibration analysis to validate robustness, decision margins, and accuracy-precision trade-offs. Experimental results show that multiple fusion techniques achieve comparable high performance and stable behavior on the APTOS 2019 benchmark, with the best configuration reaching 98.64% accuracy, 98.40% precision, 98.92% recall, 98.66% F1-score, and 99.78% Area-Under-Curve (AUC). Beyond peak accuracy, the study provides insights into ensemble reliability, calibration characteristics, and practical design choices for medical image classification systems. These results show that integrating transfer learning with CLAHE preprocessing and ensemble fusion yields stable experimental performance on the APTOS 2019 benchmark, suggesting potential for future medical decision support.

Scientific ReportsVol. 16(1)
Princess Nourah bint Abdulrahman University (SA), Jadara University (JO), Ziane Achour University of Djelfa (DZ), Higher Institute of Engineering (EG), University Mohamed Boudiaf of M'sila (DZ), KTH Royal Institute of Technology (SE), Delta University for Science and Technology (EG)
Kungliga Tekniska Högskolan
Peace, Justice and strong institutions
Openalex Percentile: Top 6%
Retinal Imaging and Analysis
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