<jats:p>At present, the early diagnosis of diabetic retinopathy (DR), a possible complication of diabetes due to elevated glucose concentrations in the blood, is usually performed by specialists using a manual inspection of high-resolution fundus images based on lesion screening, leading to problems such as high work-intensity and accessibility only in specialized health centers. To support the diagnosis of DR, we propose a deep learning-based (DL) DR lesion classification method through a knowledge distillation (KD) strategy. First, we use the pre-trained DL architecture, Inception-v3, as a teacher model to distill the dataset. Then, a student model, also using the Inception-v3 model, is trained on the distilled dataset to match the performance of the teacher model. In addition, a new combination of Kullback–Leibler (KL) divergence and categorical cross-entropy (CCE) loss is used to measure the difference between the teacher and student models. This combined metric encourages the student model to mimic the predictions of the teacher model. Finally, the trained student model is evaluated on a validation dataset to assess its performance and compare it with both the teacher model and another competitive DL model. Experiments are conducted on the two datasets, corresponding to an imbalanced and a balanced dataset. Two baseline models (Inception-v3 and YOLOv8) are evaluated for reference, obtaining a maximum training accuracy of 66.75% and 90.90%, respectively, and a maximum validation accuracy of 35.94% and 81.52%, both for the imbalanced dataset. On the other hand, the proposed DR classification model achieves an average training accuracy of 99.01% and an average validation accuracy of 97.30%, overcoming the baseline models and other state-of-the-art works. Experimental results show that the proposed model achieves competitive results in DR lesion detection and classification tasks, assisting in the early diagnosis of diabetic retinopathy.</jats:p>
