Anatomy-Slot: Unsupervised Anatomical Factorization for Homologous Bilateral Reasoning in Retinal Diagnosis

Retinal diagnosis is inherently bilateral: clinicians compare homologous structures across eyes (e.g., optic disc asymmetry), yet most deep models operate on monocular representations. We investigate whether explicit structural correspondence improves diagnosis, and propose Anatomy-Slot to operationalize this hypothesis. Anatomy-Slot introduces an unsupervised anatomical bottleneck by decomposing patch tokens into a set of emergent, structurally-coherent slots that correspond to anatomical regions, then aligning these slots across eyes via bidirectional cross-attention. On ODIR-5K with n=10 seeds, the method improves AUC by 4.2 points over a matched ViT-L baseline (95% CIs; Wilcoxon signed-rank test, W=0, p=0.002). Pairing disruption and stress testing under Gaussian noise provide controlled tests of correspondence dependence and robustness under corruption. We further report quantitative optic disc grounding on REFUGE and cross-attention localization analysis. Beyond the reported gains, these results indicate that object-centric anatomical correspondence offers a principled path toward interpretable diagnostic systems aligned with clinical bilateral comparison.