Abstract: The early detection of diabetic retinopathy is crucial for preventing blindness. However, it is time-consuming to analyze fundus images manually, especially considering the increasing amount of medical images. In this paper, we propose an automatic diabetic retinopathy screening method using color fundus images. Our approach consists of three main components:edge-guided candidate microaneurysms detection, candidates classification using mixed features, and diabetic retinopathy prediction using fused features of image level and lesion level. We divide a screening task into two sub-classification tasks:1) verifying candidate microaneurysms by a naive Bayes classifier; 2) predicting diabetic retinopathy using a support vector machine classifier. Our approach can effectively alleviate the imbalanced class distribution problem. We evaluate our method on two public databases:Lariboisière and Messidor, resulting in an area under the curve of 0.908 on Lariboisière and 0.832 on Messidor. These scores demonstrate the advantages of our approach over the existing methods.