Diabetic retinopathy (DR) is one of the main causes of impaired vision. A good and reliable automated grading system can make the screening process safer and more accurate. Because DR stages progress gradually, the task of grading disease severity naturally follows an ordinal structure in which neighboring classes share similar visual characteristics. In this study, ORViT-DR, a hybrid deep learning framework, is designed to improve DR grading from low-resolution retinal images. The proposed approach combines convolutional feature extraction with transformer-based global context modeling through a pre-trained ViT-Hybrid backbone, which integrates BiT-ResNetv2 with a Vision Transformer architecture. The approach is tested on the RetinaMNIST subset of the MedMNISTv2 dataset, which contains 28x28 retinal fundus images annotated with five levels of disease severity. To promote stable training and better feature learning, the training strategy applies progressive layer unfreezing, layer-wise learning rate decay, exponential moving average (EMA) parameter updates, and ensemble-based prediction during inference. Experimental results on the official RetinaMNIST test set show that the proposed method achieves 57.00% classification accuracy, along with a quadratic weighted kappa score of 0.5963 and a macro-F1 score of 0.4293. These results suggest that hybrid CNN-Transformer architectures can provide effective representations for ordinal retinal image analysis.
Image mixup is a widely adopted data augmentation strategy, yet it is ill-suited for ordinal classification tasks such as medical disease grading, where labels encode a progression of severity. By indiscriminately blending disease-severity cues (ordinal) with appearance-level variation (non-ordinal), standard mixup produces samples that distort the very ordinal structure that underpins clinical severity grading. We introduce DisMix, an order-aware mixup framework for ordinal classification. DisMix disentangles ordinal and non-ordinal features via a dual-codebook VQ-VAE, allowing each subspace to be mixed independently: ordinal codes are interpolated to produce meaningful intermediate ranks, while non-ordinal codes are varied to introduce appearance diversity without corrupting the ordinal signal. Across four medical imaging datasets, DisMix shows the best aggregate performance among six image mixup baselines paired with six ordinal classifiers and remains effective under data scarcity and clinical grading variability.