Interpretable Fundus Image Classification via Ring-Based Retinal Vasculature Features

Abstract

Retinal fundus photography is widely used for screening and monitoring ocular diseases, but many modern classification pipelines rely on deep latent representations and provide limited interpretability. This study develops an interpretable fundus image classification framework based on a ring-structured representation of the retinal vasculature centered on the optic disc. The method quantifies vessel geometry, color appearance, oxygenation-related vascular appearance, and vessel--background entropy within concentric retinal regions. These physiologically motivated descriptors are derived from vessel masks, image intensities, and optical-density measurements and aggregated across rings to capture spatial variation in vascular properties. Using only quantitative vascular descriptors, the proposed method achieved strong classification performance across three public fundus datasets. On HRF, it achieved 91.1\% accuracy using automatically generated vessel masks, matching RETFound, a vision transformer pretrained on large-scale retinal fundus image data, under the same evaluation setting. Additional analyses suggest that pretrained image models are sensitive to acquisition-related spatial cues, including fundus scale and retinal position within the field of view, as well as broader non-vessel image characteristics. This framework may support interpretable disease classification, quantitative retinal phenotyping, and retinal biomarker discovery without requiring large task-specific training datasets.