Clinical Scorecard: Advances in Macular Telangiectasia Type 2 Care

At a Glance

Key Highlights

• Prior to Encelto, no approved treatments slowed MacTel progression; management focused on late-stage complications like CNVM with anti-VEGF agents.
• Encelto (revakinagene taroretcel-lwey) is an encapsulated cell therapy implant delivering sustained recombinant human CNTF to slow photoreceptor loss.
• Encelto is a one-time surgical implant with a favorable risk-benefit profile and demonstrated efficacy in phase 2 and 3 clinical trials.

Guideline-Based Recommendations

Diagnosis

• Diagnosis of MacTel is clinical and imaging-based; no specific diagnostic recommendations detailed in this article.

Management

• Use Encelto implant to slow disease progression by delivering sustained CNTF to the retina.
• Treat late-stage complications such as choroidal neovascular membranes with anti-VEGF agents as needed.

Monitoring & Follow-up

• Monitor for implant-related adverse events including conjunctival erosion, implant prolapse, inflammation, infection, and bleeding.
• Assess visual function over time including reading speed and retinal sensitivity (e.g., microperimetry).

Risks

• Surgical risks include conjunctival erosion, implant prolapse, inflammation, infection, and bleeding.
• Proper surgical technique is essential to minimize suture-related complications.

Patient & Prescribing Data

Patients with MacTel without alternative approved treatments to slow progression

Encelto is a one-time surgical implant that slows photoreceptor loss and disease progression, with clinical trial data supporting preservation of reading speed and retinal sensitivity; patients should be counseled on realistic expectations regarding slowing vision loss rather than improvement.

Clinical Best Practices

• Surgeons should familiarize themselves with the prescriptive implantation technique for Encelto to reduce complications.
• Securely bury sutures to prevent conjunctival erosion and related adverse events.
• Educate patients clearly about the goal of treatment as slowing vision loss, setting appropriate expectations.
• Monitor patients longitudinally for both efficacy and implant-related adverse events.

References

• Neurotech Pharmaceuticals - Encelto (revakinagene taroretcel-lwey)
• Retinal Physician - Peer Perspectives Series