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

Mixture-of-Experts (MoE) networks promise favorable accuracy-compute trade-offs, yet practical vision deployments are hindered by expert collapse and limited end-to-end efficiency gains. We study when sparse top-$k$ routing with hard capacity constraints helps in vision classification, evaluated under multi-seed protocols on four benchmarks (CIFAR-10/100, Tiny-ImageNet, ImageNet-1K). We observe a \emph{compute-leverage pattern}: positive accuracy gaps require a substantial fraction $ρ$ of total FLOPs to be routed; at ImageNet scale this is necessary but not sufficient, as multi-expert routing ($k \geq 2$) is additionally required. Two controlled experiments isolate these factors. A hidden-size sweep on CIFAR-10 yields both predicted sign reversals across standard and depthwise backbones, ruling out backbone family as the active variable. An ImageNet-1K ablation that varies only top-$k$ -- holding architecture, initialization, and $ρ$ fixed -- reverses the gap from positive to negative across all five seeds. A per-sample variant of Soft MoE that softmaxes over experts rather than the batch rescues CIFAR-100 above the dense baseline, identifying batch-axis dispatch as the dominant failure mode in per-sample CNN settings. Code and aggregate results: https://github.com/libophd/sparse-moe-vision-rho.

Foundation models are used to extract transferable representations from large amounts of unlabeled data, typically via self-supervised learning (SSL). However, many of these models rely on architectures that offer limited interpretability, a critical issue in high-stakes domains such as medical imaging. We propose \model, a foundation model that is interpretable-by-design via a BagNet backbone whose small receptive fields generate class evidence maps that are faithful to the model's decision-making process. Additionally, \model{} incorporates a $2D$ projection layer during pretraining that enables direct visualization of the representation space, providing a dataset-level view of the learned structure including meaningful clinical clusters as well as potential spurious correlations. We trained \model{} on over 800,000 color fundus photographs from various sources to learn generalizable representations for different downstream tasks. Our model achieves performance comparable to RETFound, which has $16\times$ more parameters, while providing interpretable predictions on out-of-distribution data. These results suggest that large-scale SSL pretraining paired with inherent interpretability can lead to robust representations for retinal imaging. Code and pretrained models are available at \href{https://anonymous.4open.science/r/dual-ifm-3D5A/README.md}{www.anonymous.4open.science/dual-IFM}.

Multimodal medical anomaly detection identifies samples deviating from normal patterns, where scarce abnormal cases make normality modeling from normal data practical. In retinal Optical Coherence Tomography (OCT) and OCT Angiography (OCTA) anomaly detection, existing unsupervised methods rely on visual feature distributions, reconstruction residuals, or encoder-decoder discrepancies, making anomaly scores depend on appearance-level deviations, while multimodal normality also contains semantic organization described in normal medical reports. To this end, we propose Report-Guided Mixture-of-Experts (ReMoE), which distills normal report semantics into an image-to-text prior student, builds modality-aware priors, and uses Report-Guided Modality Modulation (RMM) to modulate features through mixture-of-experts routing. Experiments on a private OCT/OCTA dataset with paired normal reports and a public OCTA500-3MM setting using a fixed normal report demonstrate state-of-the-art performance.