Deep Learning for Multi‐Disease OCT Classification in Clinical Retina Practice Using Attention Mechanisms and Contrastive Learning

ABSTRACT

Artificial intelligence (AI) is increasingly used in ophthalmic imaging to support early detection of vision‐threatening retinal diseases such as age‐related macular degeneration, diabetic retinopathy (DR) and choroidal neovascularisation (CNV). However, optical coherence tomography (OCT)‐based deep learning models may remain sensitive to image degradation, struggle to resolve subtle inter‐class morphological differences and show reduced reliability beyond controlled benchmark settings. We propose AESNet‐SEC, a lightweight attention‐enhanced SqueezeNet framework integrating multi‐scale dilated convolutions, spatial attention, squeeze‐and‐excitation recalibration and contrastive representation learning. The framework was evaluated on the Retinal OCT‐C8 dataset (24,000 images; eight classes) and a prospectively collected clinical dataset from Zeyaei Hospital, Iran (9732 OCT B‐scans; four classes). AESNet‐SEC achieved 98.56% accuracy on OCT‐C8 and 96.33%–96.98% across four repeated clinical evaluations. Ablation and ROC analyses showed the strongest overall discrimination for the complete configuration, while controlled Gaussian‐noise testing revealed greater degradation for DR and drusen. Grad‐CAM visualisations highlighted anatomically plausible retinal regions, with independent retinal‐specialist review providing qualitative support for the observed activation patterns. Overall, AESNet‐SEC combines strong multi‐class discrimination, computational efficiency, controlled robustness and visual interpretability, while broader patient‐disjoint, multi‐centre validation remains necessary.