Like an Ophthalmologist: Dynamic Selection Driven Multi-View Learning for Diabetic Retinopathy Grading

Diabetic retinopathy (DR), with its large patient population, has become a formidable threat to human visual health. In the clinical diagnosis of DR, multi-view fundus images are considered to be more suitable for DR diagnosis because of the wide coverage of the field of view. Therefore, different from the previous single-view DR grading methods, we design a dynamic selection-driven multi-view DR grading method to fit clinical scenarios better. Since lesion information plays a key role in DR diagnosis, previous methods usually boost the model performance by enhancing the lesion feature. However, during the actual diagnosis, ophthalmologists not only focus on the crucial parts, but also exclude irrelevant features to ensure the accuracy of judgment. To this end, we introduce the idea of dynamic selection and design a series of selection mechanisms from fine granularity to coarse granularity. In this work, we first introduce an Ophthalmic Image Reader (OIR) agent to provide the model with pixel-level prompts of suspected lesion areas. Moreover, we design a Multi-View Token Selection Module (MVTSM) that prunes redundant feature tokens and dynamically selects key information. In the final decision stage, we dynamically fuse multi-view features through the novel Multi-View Mixture of Experts Module (MVMoEM), to enhance key views and reduce the impact of conflicting views. Extensive experiments on a large multi-view fundus image dataset with 34,452 images prove that our method performs favorably against state-of-the-art models.