Low-Rank Adaptive Structural Priors for Generalizable Diabetic Retinopathy Grading

Abstract: Diabetic retinopathy (DR), a serious ocular complication of diabetes, is one of the primary causes of vision loss among retinal vascular diseases. Deep learning methods have been extensively applied in the grading of diabetic retinopathy (DR). However, their performance declines significantly when applied to data outside the training distribution due to domain shifts. Domain generalization (DG) has emerged as a solution to this challenge. However, most existing DG methods overlook lesion-specific features, resulting in insufficient accuracy. In this paper, we propose a novel approach that enhances existing DG methods by incorporating structural priors, inspired by the observation that DR grading is heavily dependent on vessel and lesion structures. We introduce Low-rank Adaptive Structural Priors (LoASP), a plug-and-play framework designed for seamless integration with existing DG models. LoASP improves generalization by learning adaptive structural representations that are finely tuned to the complexities of DR diagnosis. Extensive experiments on eight diverse datasets validate its effectiveness in both single-source and multi-source domain scenarios. Furthermore, visualizations reveal that the learned structural priors intuitively align with the intricate architecture of the vessels and lesions, providing compelling insights into their interpretability and diagnostic relevance.