Early glaucoma detection using hybrid models based on deep learning in fundus images

Authors

DOI:

https://doi.org/10.51252/rcsi.v6i2.1642

Keywords:

retinal image analysis, multiclass classification, automated diagnosis, transfer learning, computer vision

Abstract

Glaucoma is one of the leading causes of irreversible blindness, making early detection essential to prevent vision loss. This study aimed to develop and evaluate hybrid deep learning models for multiclass glaucoma classification using fundus images. A total of 6,014 retinal images from public databases were used, after undergoing cleaning, balancing, and stratified splitting. The VGG16, ResNet50, and EfficientNet-B0 architectures were employed as feature extractors combined with Cascaded Deep Forest. Evaluation included stratified 10-fold cross-validation and an independent test set. VGG16 + CDF achieved the best performance, with an average accuracy of 0.9320, greater stability, and better generalization. Statistical tests confirmed significant differences among the models, demonstrating that the proposed hybrid approach is a robust alternative for automated glaucoma classification.

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References

Abramovich, O., Pizem, H., Fhima, J., Berkowitz, E., Gofrit, B., Baskin, M., Meisel, M., Eijgen, J. Van, Blumenthal, E., & Behar, J. (2026). Hillel Yaffe Glaucoma Dataset (HYGD): A Gold-Standard Annotated Fundus Dataset for Glaucoma Detection. PhysioNet. https://doi.org/https://doi.org/10.13026/m92s-0z95

Akiba, T., Sano, S., Yanase, T., Ohta, T., & Koyama, M. (2019). Optuna: A Next-generation Hyperparameter Optimization Framework. Proceedings of the 25th ACM SIGKDD International Conference on Knowledge Discovery & Data Mining, 2623–2631. https://doi.org/10.1145/3292500.3330701

Aljohani, A., & Aburasain, R. Y. (2024). A hybrid framework for glaucoma detection through federated machine learning and deep learning models. BMC Medical Informatics and Decision Making, 24(1), 115. https://doi.org/10.1186/s12911-024-02518-y

Arévalo-Hernández, C. O., Arévalo-Gardini, E., Arévalo-López, L. A., Tuesta-Hidalgo, O., Romero-Vela, D. S., & Ruiz-Camus, C. E. (2023). Predicción de la fertilidad del suelo mediante aprendizaje automático en la provincia de Alto Amazonas, Perú. Revista Peruana de Investigación Agropecuaria, 3(2), e63. https://doi.org/10.56926/repia.v3i2.63

Breiman, L. (2001). Random Forests. Machine Learning, 45(1), 5–32. https://doi.org/10.1023/A:1010933404324

Chaurasia, A. K., Liu, G.-S., Greatbatch, C. J., Gharahkhani, P., Craig, J. E., Mackey, D. A., MacGregor, S., & Hewitt, A. W. (2025). A generalised computer vision model for improved glaucoma screening using fundus images. Eye, 39(1), 109–117. https://doi.org/10.1038/s41433-024-03388-4

Chiang, Y.-Y., Chen, C.-L., & Chen, Y.-H. (2024). Deep Learning Evaluation of Glaucoma Detection Using Fundus Photographs in Highly Myopic Populations. Biomedicines, 12(7), 1394. https://doi.org/10.3390/biomedicines12071394

Demšar, J. (2006). Statistical Comparisons of Classifiers over Multiple Data Sets. JMLR. https://www.jmlr.org/papers/v7/demsar06a.html

Fumero Batista, F. J., Diaz-Aleman, T., Sigut, J., Alayon, S., Arnay, R., & Angel-Pereira, D. (2020). RIM-ONE DL: A Unified Retinal Image Database for Assessing Glaucoma Using Deep Learning. Image Analysis & Stereology, 39(3), 161–167. https://doi.org/10.5566/ias.2346

Geurts, P., Ernst, D., & Wehenkel, L. (2006). Extremely randomized trees. Machine Learning, 63(1), 3–42. https://doi.org/10.1007/s10994-006-6226-1

Govindharaj, I., Santhakumar, D., Pugazharasi, K., Ravichandran, S., Vijaya Prabhu, R., & Raja, J. (2025). Enhancing glaucoma diagnosis: Generative adversarial networks in synthesized imagery and classification with pretrained MobileNetV2. MethodsX, 14, 103116. https://doi.org/10.1016/j.mex.2024.103116

Ha, A., & Park, K. H. (2019). Optical Coherence Tomography for the Diagnosis and Monitoring of Glaucoma. Asia-Pacific Journal of Ophthalmology. https://doi.org/10.22608/APO.201902

Hassan, T., Akram, M. U., Masood, M. F., & Yasin, U. (2018). BIOMISA Retinal Image Database for Macular and Ocular Syndromes (pp. 695–705). https://doi.org/10.1007/978-3-319-93000-8_79

He, K., Zhang, X., Ren, S., & Sun, J. (2016). Deep Residual Learning for Image Recognition. 2016 IEEE Conference on Computer Vision and Pattern Recognition (CVPR), 770–778. https://doi.org/10.1109/CVPR.2016.90

Hicks, S. A., Strümke, I., Thambawita, V., Hammou, M., Riegler, M. A., Halvorsen, P., & Parasa, S. (2022). On evaluation metrics for medical applications of artificial intelligence. Scientific Reports, 12(1), 5979. https://doi.org/10.1038/s41598-022-09954-8

Hwang, E. E., Chen, D., Han, Y., Jia, L., & Shan, J. (2025). Utilization of Image-Based Deep Learning in Multimodal Glaucoma Detection Neural Network from a Primary Patient Cohort. Ophthalmology Science, 5(3), 100703. https://doi.org/10.1016/j.xops.2025.100703

Ilesanmi, A. E., Ilesanmi, T., & Gbotoso, G. A. (2023). A systematic review of retinal fundus image segmentation and classification methods using convolutional neural networks. Healthcare Analytics, 4, 100261. https://doi.org/10.1016/j.health.2023.100261

Ling, X. C., Chen, H. S.-L., Yeh, P.-H., Cheng, Y.-C., Huang, C.-Y., Shen, S.-C., & Lee, Y.-S. (2025). Deep Learning in Glaucoma Detection and Progression Prediction: A Systematic Review and Meta-Analysis. Biomedicines, 13(2), 420. https://doi.org/10.3390/biomedicines13020420

Meethal, N. S. K., Sisodia, V. P. S., George, R., & Khanna, R. C. (2024). Barriers and Potential Solutions to Glaucoma Screening in the Developing World: A Review. Journal of Glaucoma, 33(8S), S33–S38. https://doi.org/10.1097/IJG.0000000000002404

Ministerio de Salud. (2021). Minsa: Más del 50 % de los pacientes que tiene glaucoma no sabe que lo padece. Ministerio de Salud. https://www.gob.pe/institucion/minsa/noticias/346283-minsa-mas-del-50-de-los-pacientes-que-tiene-glaucoma-no-sabe-que-lo-padece?utm_source

Owusu-Adjei, M., Ben Hayfron-Acquah, J., Frimpong, T., & Abdul-Salaam, G. (2023). Imbalanced class distribution and performance evaluation metrics: A systematic review of prediction accuracy for determining model performance in healthcare systems. PLOS Digital Health, 2(11), e0000290. https://doi.org/10.1371/journal.pdig.0000290

Realini, T., McMillan, B., Gross, R. L., Devience, E., & Balasubramani, G. K. (2021). Assessing the Reliability of Intraocular Pressure Measurements Using Rebound Tonometry. Journal of Glaucoma, 30(8), 629–633. https://doi.org/10.1097/IJG.0000000000001892

Roboflow. (2026). GlaucomaData Computer Vision Model. Universe Roboflow. https://universe.roboflow.com/classification-8wwxf/glaucomadata/dataset/1

Saha, S., Vignarajan, J., & Frost, S. (2023). A fast and fully automated system for glaucoma detection using color fundus photographs. Scientific Reports, 13(1), 18408. https://doi.org/10.1038/s41598-023-44473-0

Schuster, A. K., Erb, C., Hoffmann, E. M., Dietlein, T., & Pfeiffer, N. (2020). The Diagnosis and Treatment of Glaucoma. Deutsches Ärzteblatt International. https://doi.org/10.3238/arztebl.2020.0225

Sharma, P., Takahashi, N., Ninomiya, T., Sato, M., Miya, T., Tsuda, S., & Nakazawa, T. (2025). A hybrid multi model artificial intelligence approach for glaucoma screening using fundus images. Npj Digital Medicine, 8(1), 130. https://doi.org/10.1038/s41746-025-01473-w

Shi, D., Zhang, W., Yang, J., Huang, S., Chen, X., Xu, P., Jin, K., Lin, S., Wei, J., Yusufu, M., Liu, S., Zhang, Q., Ge, Z., Xu, X., & He, M. (2025). A multimodal visual–language foundation model for computational ophthalmology. Npj Digital Medicine, 8(1), 381. https://doi.org/10.1038/s41746-025-01772-2

Shoukat, A., Akbar, S., Hassan, S. A., Iqbal, S., Mehmood, A., & Ilyas, Q. M. (2023). Automatic Diagnosis of Glaucoma from Retinal Images Using Deep Learning Approach. Diagnostics, 13(10), 1738. https://doi.org/10.3390/diagnostics13101738

Sidhu, Z., & Mansoori, T. (2024). Artificial intelligence in glaucoma detection using color fundus photographs. Indian Journal of Ophthalmology, 72(3), 408–411. https://doi.org/10.4103/IJO.IJO_613_23

Simonyan, K., & Zisserman, A. (2014). Very Deep Convolutional Networks for Large-Scale Image Recognition. Computer Vision and Pattern Recognition, 1. https://doi.org/https://doi.org/10.48550/arXiv.1409.1556

Świerczyński, H., Pukacki, J., Szczęsny, S., Mazurek, C., & Wasilewicz, R. (2025). Application of machine learning techniques in GlaucomAI system for glaucoma diagnosis and collaborative research support. Scientific Reports, 15(1), 7940. https://doi.org/10.1038/s41598-025-89893-2

Tan, M., & Le, Q. (2019). EfficientNet: Rethinking Model Scaling for Convolutional Neural Networks. Proceedings of the 36th International Conference on Machine Learning, PMLR. https://proceedings.mlr.press/v97/tan19a.html

Tham, Y.-C., Li, X., Wong, T. Y., Quigley, H. A., Aung, T., & Cheng, C.-Y. (2014). Global Prevalence of Glaucoma and Projections of Glaucoma Burden through 2040. Ophthalmology, 121(11), 2081–2090. https://doi.org/10.1016/j.ophtha.2014.05.013

Zhou, Z.-H., & Feng, J. (2019). Deep forest. National Science Review, 6(1), 74–86. https://doi.org/10.1093/nsr/nwy108

Published

2026-07-20

How to Cite

Ramírez-Cenepo , L. E., Ruiz-Cueva, J. A., Sánchez-Flores , J., Rojas-Córdova, K. L., Leveau-Paredes, M. G., & Llontop-Reategui, A. R. (2026). Early glaucoma detection using hybrid models based on deep learning in fundus images. Revista Científica De Sistemas E Informática, 6(2), e1642. https://doi.org/10.51252/rcsi.v6i2.1642