# Disentangling Co-Occurring Retinal Pathologies with Saliency-Guided Sparse Expert Routing

arXiv: https://arxiv.org/abs/2608.09752 · HTML: https://mlsanity.com/paper/2608.09752/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical and biomedical MoE, one of 12 directions in Mixture-of-experts.
- Builds on 18 of its 22 references that are in the map.
- First posted on arXiv 10 Aug 2026.

## Placed in

- Mixture-of-experts / [Medical and biomedical MoE](https://mlsanity.com/moe/medical-and-biomedical-moe/)

## Builds on (most cited first, 18 of 18)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Squeeze-and-Excitation Networks](https://mlsanity.com/paper/1709.01507/) (2017)
- [A ConvNet for the 2020s](https://mlsanity.com/paper/2201.03545/) (2022)
- [Outrageously Large Neural Networks: The Sparsely-Gated Mixture-of-Experts Layer](https://mlsanity.com/paper/1701.06538/) (2017)
- [Switch Transformers: Scaling to Trillion Parameter Models with Simple and Efficient Sparsity](https://mlsanity.com/paper/2101.03961/) (2021)
- [CBAM: Convolutional Block Attention Module](https://mlsanity.com/paper/1807.06521/) (2018)
- [Non-local Neural Networks](https://mlsanity.com/paper/1711.07971/) (2017)
- [GLU Variants Improve Transformer](https://mlsanity.com/paper/2002.05202/) (2020)
- [Root Mean Square Layer Normalization](https://mlsanity.com/paper/1910.07467/) (2019)
- [Grad-CAM++: Improved Visual Explanations for Deep Convolutional Networks](https://mlsanity.com/paper/1710.11063/) (2017)
- [DeepSeekMoE: Towards Ultimate Expert Specialization in Mixture-of-Experts Language Models](https://mlsanity.com/paper/2401.06066/) (2024)
- [Scaling Vision with Sparse Mixture of Experts](https://mlsanity.com/paper/2106.05974/) (2021)
- [GCNet: Non-local Networks Meet Squeeze-Excitation Networks and Beyond](https://mlsanity.com/paper/1904.11492/) (2019)
- [A Benchmark of Ocular Disease Intelligent Recognition: One Shot for Multi-disease Detection](https://mlsanity.com/paper/2102.07978/) (2021)
- [Guided Context Gating: Learning to leverage salient lesions in retinal fundus images](https://mlsanity.com/paper/2406.13126/) (2024)
- [Discriminative Kernel Convolution Network for Multi-Label Ophthalmic Disease Detection on Imbalanced Fundus Image Dataset](https://mlsanity.com/paper/2207.07918/) (2022)
- [Ordinal Label-Distribution Learning with Constrained Asymmetric Priors for Imbalanced Retinal Grading](https://mlsanity.com/paper/2509.26146/) (2025)

## Abstract (arXiv)

Retinal fundus images frequently exhibit multiple co-occurring pathologies, yet standard deep learning classifiers apply static, identical computation to every image regardless of the underlying disease distribution. We propose a novel architecture that resolves this via sparse conditional computation, pairing a Guided Context Gating (GCG) spatial attention front-end with a sparsely-routed Mixture-of-Experts (MoE) block operating over feature tokens. Crucially, this routing yields an interpretable, data-driven decomposition. Expert allocation is significantly disease-dependent (p < 0.001), with the healthy Normal state and morphologically distinct pathologies (e.g., ERM, AMD) isolating to dedicated experts. On a five-class, patient-disjoint 5-fold cross-validation benchmark, our model achieves 0.912 +/- 0.008 macro AUC and 0.653 +/- 0.014 macro F1. Furthermore, Grad-CAM++ and post-MoE t-SNE visualizations confirm that expert routing aligns with localized lesions and geometrically maps co-occurring cases between their constituent clusters, positioning sparse MoE as an interpretable approach to multi-disease retinal screening.