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Retinex: AI-Assisted Diabetic Retinopathy Screening

Retinex is a full-stack clinical decision support system (CDSS) designed for early screening of Diabetic Retinopathy (DR) in resource-constrained environments like Tier-2 cities and rural clinics. It integrates state-of-the-art AI vision models with systemic diabetes risk analysis to provide a unified risk score and clear clinical guidance.


🏗️ Architecture Overview

Retinex follows a modern, scalable serverless architecture:

flowchart TD
    A[Frontend]
    
    B[API Layer]
    
    C[AI Engine - Fundus Analysis]
    C1[DR Classification Model]
    C2[Grad-CAM Generator]
    
    D[CDSS Engine - Diabetes Analysis]
    
    E[Fusion Layer - Combine Risk Scores]
    
    F[Doctor Dashboard]
    G[Annotation and Diagnosis]
    
    H[Backend - Supabase & Node.js]
    
    I[Gemini API - Patient Summary]
    
    A --> B
    B --> C
    B --> D
    
    C --> C1
    C --> C2
    
    C --> E
    D --> E
    
    E --> F --> G
    
    G --> H
    H --> I
    I --> A
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⚙️ System Workflow

The system implements a multi-stage logic pipeline for screening.

flowchart TD
    A[User uploads fundus image]
    B[Image quality check]
    C{Is image valid?}
    D[Prompt recapture image]

    E[Send image to AI Engine]
    F[Preprocessing]
    G[Fundus DR Classification Model]
    H[Generate DR Score and Confidence]
    I[Generate Grad-CAM Heatmap]

    J[Send patient data to AIIMS CDSS API]
    K[Diabetes Detection and Risk Analysis]

    L[Combine Diabetes Risk and Fundus DR Score]

    M[Send combined report to Doctor Dashboard]
    N[Doctor reviews report and heatmap]
    O[Doctor annotates posterior and anterior fundus]
    P[Doctor provides final diagnosis and recommendation]

    Q[Store results in Supabase]
    R[Generate patient-friendly summary via Gemini API]
    S[Send SMS notification to patient]
    T[End]

    A --> B --> C
    C -->|No| D --> A
    C -->|Yes| E --> F --> G --> H --> I

    A --> J --> K

    H --> L
    K --> L

    L --> M --> N --> O --> P --> Q --> R --> S --> T
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👥 User Flow

Designed for ease of use by non-specialists in rural field clinics.

flowchart TD
    A[Patient arrives at clinic]
    B[Health worker logs into system]
    C[Capture fundus image]
    D[Enter basic patient details]
    
    E[System processes data]
    F[AI Fundus Analysis]
    G[AIIMS CDSS Diabetes Analysis]
    
    H[Combined risk generated]
    I[Doctor reviews case]
    J[Doctor adds annotations and diagnosis]
    
    K[Final result shown to patient]
    L[SMS sent for follow-up]
    M[End]

    A --> B --> C --> D --> E
    E --> F
    E --> G
    F --> H
    G --> H
    H --> I --> J --> K --> L --> M
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💾 Database Schema

Retinex utilizes a structured PostgreSQL schema optimized for clinical screening and doctor-in-the-loop review.

Core Tables

Table Purpose
profiles Stores user profile data and links to auth identities.
user_roles Manages permissions (asha_worker, doctor, admin).
patients Demographic data and systemic history (Diabetes duration, medication).
screenings Individual screening sessions (image URL, status, capture metadata).
ai_results Results from multiple AI models (DR class, confidence, CDSS score, Unified Risk).
doctor_reviews Clinical decisions, annotations (Posterior & Anterior), and AI-generated summaries.

✨ Features & Clinical Impact

🚀 Key Features

  • Explainable AI (XAI): Moves beyond "black box" AI by highlighting precisely where the model found anomalies.
  • Unified Risk Fusion: Combines retinal findings with systemic history to prevent false negatives.
  • Mobile-First Design: Fully responsive UI for tablets/smartphones used in the field.
  • Offline-Ready Support: Designed for deployment in areas with intermittent connectivity.
  • Multi-lingual AI Summaries: Translates clinical findings into patient-friendly language.

🏥 Clinical Impact

  • Increased Reach: Enables non-specialists (ASHA workers) to perform screenings locally.
  • Efficiency: Reduces specialist burden by highlighting only cases needing immediate intervention.
  • Patient Adherence: Clear, actionable summaries and SMS follow-ups improve follow-up rates.
  • Standards Compliance: Follows AIIMS and NHM screening guidelines.

🛠️ Getting Started

Prerequisites

  • Node.js & npm
  • Supabase CLI
  • Python 3.9+ (for AI engine)

Local Setup

  1. Clone & Install:
    npm install
  2. Supabase Setup:
    supabase start
    supabase db reset
  3. AI Engine:
    cd ai-engine
    pip install -r requirements.txt
    python main.py
  4. Start App:
    npm run dev

Built with ❤️ for rural healthcare and accessible screening.

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