Diabetic retinopathy (DR) is on the increase nowadays due to the high sugar level in the blood, and it is the reason for blindness that mainly occurs in middle-aged people. Furthermore, the Internet of Medical Things (IoMT) enabled computer-aided diagnostic (CAD) systems record DR-related data online and give patients with reassuring information. The internet allows for the interconnection of a variety of smart devices, enabling remote healthcare systems based on the IoMT to link patients with medical professionals. The proper diagnosis of diabetic patients and detection of DR severity in earlier stages help in preventing blindness. Therefore, the basic aim of this study is to prevent the diabetic patient from losing vision by detecting and classifying the severity of DR fundus images using the IoMT-enabled CAD system. This article designed a novel diabetic retinopathy classification (DRC) system by hybridizing the DL model with optimization algorithms to classify the DR images based on severity. This system begins with preprocessing phase for removing the noise from edges. Next, the proposed K-mean cluster-based growing region segmentation is employed to extract the useful region from the images. Then, pretrained convolutional neural network (CNN) model, i.e., RESnet with the proposed hybrid genetic and ant colony optimization (HGACO) algorithm, is applied to extract the features from the region of interest (ROI) and classify them into four severity levels. Performance indices such as AUC, <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$F$</tex-math> </inline-formula> -measure, accuracy, sensitivity, and specificity are analyzed to evaluate the performance on MESSIDOR dataset. The performance of the proposed DRC system is compared with state-of-the-art classification systems. The proposed HGACO algorithm is also compared with Adam and gradient descent (GD) optimizers. The system is also evaluated by employing different parameters of CNN and HGACO. Additionally, for the determination of the classification accuracy of the DRC system, the confidence interval statistical test is implemented considering various parameters and configurations of the neural network. The results revealed that the proposed DR system provides higher classification results by achieving 95.78%, 91.98%, 97.7%, and 94.56% AUC, sensitivity, accuracy, and specificity rate, respectively. CNN alleviates the difficulty of developing image features, whereas the HGACO algorithm-based technique automates CNN hyperparameter design.
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