AUTHOR=Deepsahith K. V. , Shashank Basineni , Kumar Bangipavan , Alphonse Sherly , Subburaj Brindha , Subramanian Girish 
  
TITLE=Graph-enhanced multimodal fusion of vascular biomarkers and deep features for diabetic retinopathy detection
  
JOURNAL=Frontiers in Artificial Intelligence
  
VOLUME=Volume 8 - 2025
  
YEAR=2026
  
URL=https://www.frontiersin.org/journals/artificial-intelligence/articles/10.3389/frai.2025.1731633
  
DOI=10.3389/frai.2025.1731633
  
ISSN=2624-8212
  
ABSTRACT=Diabetic retinopathy (DR) detection can be performed through both deep retinal representations and vascular biomarkers. This proposed work suggests a multimodal framework that combines deep features with vascular descriptors in transformer fusion architecture. Fundus images are preprocessed using CLAHE, Canny edge detection, Top-hat transformation, and U-Net vessel segmentation. Then, the images are passed through a convolutional block attention module (CBAM)-fused enhanced MobileNetV3 backbone for deep spatial feature extraction. In parallel, the segmented vasculature is skeletonized to create a vascular graph, and the descriptors are computed using fractal dimension analysis (FDA), artery-to-vein ratio (AVR), and gray level co-occurrence matrix (GLCM) texture. A graph neural network (GNN) then generates a global topology-aware embedding using all that information. The different modalities are integrated using a transformer-based cross-modal fusion, where the feature vectors from MobileNet and GNN-based vascular embeddings interact using multi-head cross-attention. The fused representation is then given to a Softmax classifier for DR prediction. The model demonstrates superior performance compared to traditional deep learning baselines, achieving an accuracy of 93.8%, a precision of 92.1%, a recall of 92.8%, and an AUC-ROC of 0.96 for the DR prediction in the Messidor-2 dataset. The proposed approach also achieves above 98% accuracy for Eyepacs and APTOS 2019 datasets for DR detection. The findings demonstrate that the proposed system provides a reliable framework compared with the existing state-of-the-art methods.