What is macular telangiectasia (MacTel)?
Macular telangiectasia is a disorder of the tiny blood vessels located in the center of the retina. The retina in your eye is like the film inside a camera. The retina “takes the picture” of objects you look at and sends the message to the brain. The macula is the central portion of the retina that is responsible for sharp reading vision. In MacTel the macula undergoes slow degeneration, and tiny foveal blood vessels become irregular and dilated for unknown reasons. They rarely leak blood or clear fluid in the macula.
What is Encelto?
Encelto is a treatment for MacTel approved by the FDA in 2025. It consists of cells programed to produce ciliary neurotrophic factor (CNTF) encapsulated in a semipermeable cylinder that is sutured inside the eye at surgery. CNFT is a cytokine (cell signaling chemical) that is produced by cells in the eye to protect retinal cells.
How does Encelto help treat MacTel?
By producing CNTF, Encelto slows the rate of deterioration in MacTel. Without treatment, there is a slow loss of central vision with blind spots and distortion from MacTel. Although Encelto does not improve the vision, it does appear to slow further loss of vision over time.
What are the risks of Encelto treatment?
Common side effects of Encelto are usually mild and self-limited. They include eye discomfort/pain, inflammation, redness, tearing, and blurred vision after surgery to implant the device. Sometimes, the pupil of the eye remains smaller than normal. This may create cosmetic concerns and sometimes causes delayed dark adaptation (23%) in the treated eye. Serious risks of Encelto treatment are not common (5%), but important to understand and accept. They include suture exposure (a suture is used to attach the Encelto implant inside the eye, attached to the eye wall), bleeding inside the eye, infection inside the eye, cataract, and retinal detachment. Sometimes, additional surgery is needed. Finally, there is no information of the use of Encelto in pregnant or breast-feeding women.
What other treatment is available?
There is no cure, but treatment may improve vision or keep the vision from worsening in certain instances. No specific treatment may be recommended if the symptoms are mild. There is limited experience with L-serine supplements. Medicine injections help selected patients with macular neovascularization. Treatment usually does not return the vision to normal.
Your doctor is going to order appropriate tests and recommend the best course of action to take at this time. Physical activity and use of your eyes will not worsen macular telangiectasia. Magnification may help with reading. The doctors at RVAF are experts in the diagnosis and treatment of MacTel. If you have any questions, please feel free to ask.
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