Prevalence of Systemic Comorbidities and Ocular Complications in Patients With Bilateral Retinal Telangiectasia

<b>Purpose:</b> To compare systemic comorbidities in bilateral retinal telangiectasia, a proxy for macular telangiectasia (MacTel) type 2, vs matched controls. <b>Methods:</b> We conducted a retrospective cohort study of a large electronic health research network of patients who were older than 45 years at bilateral retinal telangiectasia diagnosis vs controls receiving eye care. Patients with macular edema or exudative age-related macular degeneration were excluded. Propensity score matching was performed on demographics. The prevalence of hypertension, diabetes mellitus, obesity, hyperlipidemia, and death within 5 years of retinal telangiectasia diagnosis or eye care visit were compared. <b>Results:</b> 2320 patients with bilateral retinal telangiectasia and 1 671 600 patients with an eye care visit were included. After matching, no demographic differences persisted. Bilateral retinal telangiectasia (vs control) patients had higher rates of type 2 diabetes mellitus (32.8% vs 20.7%; odds ratio [OR], 1.87; 95% CI, 1.64-2.14; <i>P</i> < .005) and obesity (19.9% vs 16.9%; OR 1.22; 95% CI:1.05-1.42; <i>P</i> = .01) and a lower rate of hyperlipidemia (32.0% vs 39.5%; OR 0.71; 95% CI, 0.63-0.80; <i>P < .</i>005). No differences occurred in hypertension or death. <b>Conclusions:</b> Retinal telangiectasia and MacTel type 2 are uncommon and poorly understood, with high coexisting rates of diabetes and obesity. Systemic disease associations should be investigated to identify disease interactions, the impact of systemic interventions, and leads for potential new treatments.