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Long-tailed multi-label retinal disease classification using alternate group training and gradient-based re-weighting
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  • Published: 24 April 2026

Long-tailed multi-label retinal disease classification using alternate group training and gradient-based re-weighting

  • Yingying Jian1,
  • Xiaoyan Jia1,
  • Han Zhang2,
  • Qian Zhou3 &
  • …
  • Canhua Xu1 

Scientific Reports (2026) Cite this article

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We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Computational biology and bioinformatics
  • Diseases
  • Health care
  • Mathematics and computing

Abstract

Ocular diseases have emerged as the leading causes of blindness and low vision, necessitating timely detection and treatment. However, computer-aided approaches face significant challenges in accurately diagnosing these diseases. Specifically, ocular diseases often exhibit a long-tailed distribution, leading to a complex class-imbalanced scenario. Moreover, the coexistence of multiple diseases in a single patient gives rise to a problematic issue of label co-occurrence. In this study, we propose a novel alternate group training strategy as an effective approach to tackle the multi-label long-tailed data distribution problem. Firstly, we partition the long-tailed data into several groups based on semantic feature relations. This division helps reduce the challenges of class imbalance and label co-occurrence. With these groups established, we employ a gradient-based self-weighted loss to train a teacher network in an alternate way. Furthermore, a student model is trained on the original dataset under the guidance of the teacher network, utilizing a weighted class-balanced distillation loss. The class-balanced distillation loss also alleviates the class-wise imbalanced distribution and instance-wise label co-occurrence. Extensive experimental results have demonstrated the superiority of our proposed method which achieves promising performance on the publicly available dataset. In addition, our approach achieves promising performance when expanding the single-teacher model to multiple-teacher models.

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Funding

This work was supported in part by the National Natural Science Foundation of China under Grant 31771073.

Author information

Authors and Affiliations

  1. Department of Biomedical Engineering, Fourth Military Medical University, Xi’an, 710032, Shaanxi, China

    Yingying Jian, Xiaoyan Jia & Canhua Xu

  2. Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi’an, 710032, Shaanxi, China

    Han Zhang

  3. School of Computer Science, Wuhan University, Wuhan, 430072, Hubei, China

    Qian Zhou

Authors
  1. Yingying Jian
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  2. Xiaoyan Jia
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  3. Han Zhang
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  4. Qian Zhou
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  5. Canhua Xu
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Corresponding authors

Correspondence to Qian Zhou or Canhua Xu.

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Competing interests

The authors declare no competing interests.

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Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

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Cite this article

Jian, Y., Jia, X., Zhang, H. et al. Long-tailed multi-label retinal disease classification using alternate group training and gradient-based re-weighting. Sci Rep (2026). https://doi.org/10.1038/s41598-026-47858-z

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  • Received: 11 November 2025

  • Accepted: 03 April 2026

  • Published: 24 April 2026

  • DOI: https://doi.org/10.1038/s41598-026-47858-z

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Keywords

  • Ocular disease recognition
  • Long-tailed classification
  • Knowledge distillation
  • Alternate group training
  • Re-weighting
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