Increased Prevalence of Hearing Loss and Tinnitus in Patients with Retinal Vein Occlusion

CLINICAL QUESTION

Is retinal vein occlusion associated with a higher prevalence of tinnitus, hearing loss, vertigo, or sudden deafness?

BOTTOM LINE

Patients with retinal vein occlusion had modest but statistically significantly higher odds of tinnitus and hearing loss compared with matched comparison patients. No significant association was found between retinal vein occlusion and vertigo or sudden deafness.

BACKGROUND: Retinal vein occlusion is one of the most common retinal vascular disorders and is associated with traditional cardiovascular risk factors such as hypertension and diabetes. Because the retina and cochlea both rely on vulnerable microvascular circulation, retinal vascular abnormalities may reflect broader systemic vascular diseases that could also affect auditory function.

STUDY DESIGN: Retrospective population-based observational study using Taiwan’s Longitudinal Health Insurance Database 2010. Adults diagnosed with retinal vein occlusion from 2015 to 2021 were compared with patients without retinal vein occlusion using 3:1 propensity score matching. The propensity score for developing retinal vein occlusion included variables such as age, gender, monthly income, geographic region, urbanization level, diabetes, hypertension, hyperlipidemia, and rheumatoid arthritis.

SETTING: Taiwan National Health Insurance claims database

SYNOPSIS: The study included 6,403 patients with retinal vein occlusion and 19,209 matched comparison patients, for a total cohort of 25,612 individuals. The mean age of the retinal vein occlusion group was 65.98 years, and 51.37% were male. After propensity score matching, demographic characteristics and comorbidities were well balanced between groups.

Patients with retinal vein occlusion had a higher prevalence of tinnitus than comparison patients (13.90% versus 11.58%; P<0.001) and a higher prevalence of hearing loss (10.15% versus 8.39%; P<0.001). In contrast, there were no statistically significant differences in vertigo (4.86% versus 4.61%; P=0.412) or abrupt deafness (1.44% versus 1.16%; P=0.083).

After multivariable adjustment, retinal vein occlusion remained associated with increased odds of tinnitus (adjusted OR, 1.236; 95% CI, 1.136 to 1.344) and hearing loss (adjusted OR, 1.240; 95% CI, 1.125 to 1.366). Associations with sudden deafness and vertigo remained nonsignificant.

The authors suggest that retinal vein occlusion and auditory symptoms may share systemic microvascular mechanisms, including endothelial dysfunction, vascular permeability changes, and impaired small-vessel perfusion. The effect sizes were modest, however, and the study cannot establish causality or temporal sequence. Important limitations include reliance on ICD codes rather than objective audiometry, lack of retinal vein occlusion severity or laterality data, and residual confounding from unmeasured factors such as smoking, body mass index, and potentially ototoxic medication exposure. These findings support considering a multidisciplinary approach in managing retinal vein occlusion, along with audiologic assessment and managing vascular risk factors.

CITATION: Hung SH, et al. Increased prevalence of hearing loss and tinnitus in patients with retinal vein occlusion. Sci Rep. 2026. doi:10.1038/s41598-026-52784-1.