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Existing Solutions for multi-class DR identification are computationally intensive and also suffer from low accuracy. There is an immense need for an automated, computationally efficient approach for monitoring DR progression in diabetic patients. The study proposed Random Forest (RF), Logistic Regression (LR), Decision Tree (DT), and Gaussian Naive Bayes (GNB) models for the classification of retinal images into five DR classes (No, Mild, Moderate, Proliferate, and Severe) using spatial features extracted through a Convolutional Neural Network (CNN), textural features extracted through a Grey Level Co-occurrence Matrix (GLCM), and hybrid features by combining these features. The CNN, EfficientNet, PyramidCNN, and Pyramid Vision Transformer (PVT) were also evaluated for the classification of DR stages. The results revealed that the RF model with hybrid features outperformed, with an accuracy of 98.00% and high performance across all evaluation metrics, with a 1.00% increase over existing approaches. The EfficientNet model also performs competitively with 97.00% accuracy. The ML models also emerged as computationally efficient in terms of training and inference time for deployment in low-resource clinical environments for automated monitoring of DR progression in diabetic patients.<\/jats:p>","DOI":"10.1177\/14604582261464215","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T11:11:13Z","timestamp":1782990673000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A hybrid approach for diabetic retinopathy stages classification using spatial and textural features"],"prefix":"10.1177","volume":"32","author":[{"given":"Mohsan","family":"Naqi","sequence":"first","affiliation":[{"name":"The Superior University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Arfan","family":"jaffar","sequence":"additional","affiliation":[{"name":"The Superior University"},{"name":"Intelligent Data Visual Computing Research (IDVCR)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7409-1775","authenticated-orcid":false,"given":"Rab Nawaz","family":"Bashir","sequence":"additional","affiliation":[{"name":"COMSATS University Islamabad"},{"name":"Vehari Campus"},{"name":"Prince Sultan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahir","family":"Rashid","sequence":"additional","affiliation":[{"name":"COMSATS University Islamabad"},{"name":"Vehari Campus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bayan","family":"AlGhofaily","sequence":"additional","affiliation":[{"name":"Prince Sultan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor","family":"Ayesha","sequence":"additional","affiliation":[{"name":"CYBEX Prince Sultan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faten S","family":"Alamri","sequence":"additional","affiliation":[{"name":"Princess Nourah Bint Abdulrahman University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"e_1_3_5_2_2","unstructured":"IDF Diabetes Atlas 2025. 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