At AAO 2025, the American Academy of Ophthalmology’s annual meeting, Texas Retina’s Dr. Ashkan Abbey moderated a case-based roundtable discussion about the evolving landscape of macular telangiectasia (MacTel) type 2 care, including the newly FDA-approved Encelto (NT-501 implant). He recently shared highlights from that session in a Modern Retina video series recap.
“With Encelto now available, we finally have a true disease-modifying therapy for patients who previously had no meaningful options,” explains Dr. Abbey. “A primary focus of our discussion at AAO and this video series is patient selection for this promising new therapy.”
In the video series, Dr. Abbey also highlights that although MacTel type 2 has traditionally been labeled rare, it may often go underdiagnosed due to subtle findings that can be detected through advanced imaging techniques like optical coherence tomography (OCT), fluorescein angiography (FA), and optical coherence tomography angiography (OCT-A).
What is Macular Telangiectasia (MacTel)?
Macular telangiectasia (MacTel) is an eye condition that affects the macula. While there are several types, type 2 is the most common. It develops when there are problems with the tiny blood vessels around the fovea, located in the center of the macula and responsible for the sharpest central vision. In more advanced cases of Mac-Tel type 2, new blood vessels form under the retina and can leak fluid or bleed, which is called subretinal neovascularization, or it can also progress to development of a macular hole.
MacTel type 2 usually affects both eyes, but one eye may be worse than the other. It is most often diagnosed between the ages of 40-50, and risk factors include diabetes, smoking and high blood pressure. Symptoms often develop gradually and can include the following:
- Blurry or distorted central vision
- Difficulty with reading
- Trouble seeing at night
- Formation of a dark spot
- Straight lines appearing wavy
How Encelto (NT-501) Therapy Works
A cell-based gene therapy, Encelto is a small capsule, about the size of a grain of rice, that is surgically placed inside the eye to release a naturally occurring protein called ciliary neurotrophic factor (CNTF). The capsule contains living cells that have been genetically modified to continuously produce and release CNTF, which can directly reach the retina and help preserve certain light-sensing cells in the retina known as photoreceptors, slowing the rate of vision loss.
“In the clinical studies that led to its approval, Encelto reduced the rate of photoreceptor loss by up to 54% through 24 months,” says Dr. Abbey. “This provides new hope for patients. Evolving imaging modalities like OCT-A and the approval of Encelto therapy are transforming Mac-Tel type 2 from a diagnostic challenge into a treatable condition.”
Click HERE to view the full video series or HERE to learn more about Mac-Tel Type 2.
Dr. Abbey cares for patients in our Dallas Main and Rockwall offices and also serves as Texas Retina’s Director of Clinical Research for Dallas. You can learn more about him here.