Abstract
Retinal vessel segmentation is critical for early diagnosis of diabetic retinopathy, yet existing deep models often compromise accuracy for complexity. We propose DSAE-Net, a lightweight dual-stage network that addresses this challenge by (1) introducing a Parameterized Cascaded W-shaped Architecture enabling progressive feature refinement with only 1% of the parameters of a standard U-Net; (2) designing a novel Skeleton Distance Loss (SDL) that overcomes boundary loss limitations by leveraging vessel skeletons to handle severe class imbalance; (3) developing a Cross-modal Fusion Attention (CMFA) module combining group convolutions and dynamic weighting to effectively expand receptive fields; and (4) proposing Coordinate Attention Gates (CAGs) to optimize skip connections via directional feature reweighting. Evaluated extensively on DRIVE, CHASE_DB1, HRF, and STARE datasets, DSAE-Net significantly reduces computational complexity while outperforming state-of-the-art lightweight models in segmentation accuracy. Its efficiency and robustness make DSAE-Net particularly suitable for real-time diagnostics in resource-constrained clinical settings.