Background: The inner ear is poorly vascularised and can be damaged by hypoxia related to old age, obesity and sleep apnea syndrome (OSAS). It is possible that these factors are also the basis of retinal pathologies. Materials and methods: In this retrospective study, 20 OSAS-overweight patients and 20 healthy individuals were compared to assess the association between the audio-vestibular and retinal alterations and the degree of OSAS. All Subjects were subjected to polysomnography, morphometric evaluation, audiometry, vestibular potentials (C-VEMPs, O-VEMPs), Video-HIT and retinal evaluation. Results: Regarding audio-vestibular disorders, statistically significant differences were found between OSAS patients and normal subjects on all the parameters considered. No retinal evaluation differences were observed. Discussion: Obesity and OSAS can affect auditory and vestibular function proportionally with both the degree of OSAS and obesity. This correlation can be prevented with apneas treatment and the avoidance of obesity control and its risk factors editable. Conclusion: Our results highlight that audio-vestibular screening of obese and OSAS patients in the early stage also suggests microvascular alterations and, therefore, a greater cardiovascular risk, better than retinal evaluation; this risk could be reduced by early treatment for OSAS and obesity.