Bustos-Merlo Antonio, Dominguez-Perez Juana, Olvera-Porcel María Del Carmen, Espejo-González Antonio, Espinosa-Sanchez Juan Manuel, Navarrete-Navarrete Nuria
Autoinmune and Systemic Diseases Unit, Department of Internal Medicine, Hospital Virgen de las Nieves, 18014 Granada, Spain.
Division of Otoneurology, Department of Otolaryngology, Hospital Virgen de las Nieves, 18014 Granada, Spain.
J Clin Med. 2025 May 17;14(10):3517. doi: 10.3390/jcm14103517.
Idiopathic immune-mediated uveitis (IIMU) is an intraocular inflammatory condition affecting the uveal tract and adjacent ocular structures, potentially leading to systemic involvement. Audiovestibular symptoms, such as sensorineural hearing loss (SNHL) and balance disturbances, are often underdiagnosed in these patients. The potential correlation between IIMU and audiovestibular dysfunction remains insufficiently studied. This study aimed to estimate the prevalence and describe the clinical characteristics of audiovestibular manifestations in patients with IIMU. We conducted a cross-sectional observational study of 34 patients with a confirmed diagnosis of IIMU at a tertiary academic center. All participants underwent a standardized neurootological assessment, including pure-tone audiometry, video head impulse testing (vHIT), and cervical vestibular-evoked myogenic potentials (cVEMP). Demographic and clinical data were also collected. Audiovestibular dysfunction was identified in 41.18% of patients, with bilateral SNHL (B-SNHL) being the most common finding. Patients with B-SNHL had a significantly later age of uveitis onset (52.3 ± 14.4 vs. 35.9 ± 13.9 years, = 0.003) and a higher incidence of ocular complications (83.3% vs. 59.1%, = 0.252). Furthermore, worsening ophthalmologic activity was observed in 25% of patients with B-SNHL, compared to 0% in those without B-SNHL ( = 0.037). Vestibular dysfunction was also associated with delayed onset of uveitis (51.0 ± 17.4 vs. 36.0 ± 12.2 years, = 0.006) and a non-significantly higher complication rate (76.9% vs. 61.9%, = 0.465). Audiovestibular dysfunction is a frequent finding in patients with IIMU and is associated with delayed uveitis onset and greater ocular morbidity. These results support the inclusion of systematic audiovestibular screening in clinical evaluations of IIMU patients and suggest that earlier detection may inform prognosis and guide multidisciplinary management strategies.
特发性免疫介导性葡萄膜炎（IIMU）是一种影响葡萄膜及相邻眼结构的眼内炎症性疾病，可能导致全身受累。听觉前庭症状，如感音神经性听力损失（SNHL）和平衡障碍，在这些患者中常常诊断不足。IIMU与听觉前庭功能障碍之间的潜在相关性仍研究不足。本研究旨在评估IIMU患者听觉前庭表现的患病率并描述其临床特征。我们在一家三级学术中心对34例确诊为IIMU的患者进行了一项横断面观察性研究。所有参与者均接受了标准化的神经耳科学评估，包括纯音听力测定、视频头脉冲测试（vHIT）和颈前庭诱发肌源性电位（cVEMP）。还收集了人口统计学和临床数据。41.18%的患者存在听觉前庭功能障碍，双侧SNHL（B-SNHL）是最常见的表现。B-SNHL患者葡萄膜炎发病年龄显著较晚（52.3±14.4岁 vs. 35.9±13.9岁，P = 0.003），眼部并发症发生率更高（83.3% vs. 59.1%，P = 0.252）。此外，25%的B-SNHL患者出现眼科活动恶化，而无B-SNHL患者中这一比例为0%（P = 0.037）。前庭功能障碍也与葡萄膜炎发病延迟有关（51.0±17.4岁 vs. 36.0±12.2岁，P = 0.006），并发症发生率略高（76.9% vs. 61.9%，P = 0.465）。听觉前庭功能障碍在IIMU患者中很常见，且与葡萄膜炎发病延迟和更高的眼部发病率相关。这些结果支持在IIMU患者的临床评估中纳入系统性听觉前庭筛查，并表明早期发现可能有助于判断预后并指导多学科管理策略。
