Automated fine-grained diabetic retinopathy (DR) grading was of great significance for assisting ophthalmologists in monitoring DR and designing tailored treatments for patients. Nevertheless, it is a challenging task as a result of high intra-class variations, high inter-class similarities, small lesions, and imbalanced data distributions. The pivotal factor for the success in fine-grained DR grading is to discern more subtle associated lesion features, such as microaneurysms (MA), Hemorrhages (HM), soft exudates (SE), and hard exudates (HE)....