Macular Telangiectasia (MacTel) type 2, previously thought to be a vascular condition, is a rare, progressive neurodegenerative disease of the macula. The condition predominantly affects women over the age of 40 years. As the disease advances, patients have progressive loss of central vision. Recently, the first treatment for MacTel 2 received FDA approval and is expected to be available to patients in the US as early as June 2025. 

In our Guidelines Real Time/What’s Changed Series, we typically focus on the most recent guidelines in the field. Currently, there are no specific guidelines for the treatment of MacTel type 2 in the US, likely due to the recent approval of the first treatment for MacTel type 2. However, we have identified a systematic review on the management of MacTel type 2, which is outlined below. Additionally, we will highlight the first and only FDA approved treatment for MacTel type 2. 

Part 1 – Current MacTel Type 2 Guidelines

As previously mentioned, there are currently no established guidelines in the United States for the treatment of MacTel type 2. Therefore, we have included a systematic review document as a point of reference.

Part 2 - Recent FDA Approvals

Below, is the first and only therapy recently approved by the FDA that we anticipate being incorporated into future US guidelines:

  • ENCELTO (Revakinagene taroretcel-Iwey) surgical intravitreal implantation
    • Neurotech
    • FDA approved for MacTel type 2 on March 6, 2025
    • ENCELTO is an allogenic encapsulated cell-based gene therapy indicated for the treatment of adults with idiopathic macular telangiectasia type 2.

Thank you for taking the time to review the current MacTel type 2 guidelines/consensus, as well as the recent major changes and FDA approvals that have recently occurred. We value your feedback and would like to hear your suggestions for future topics to be covered in our guideline series. Please feel free to contact us with any ideas or questions you may have.

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