Table of ContentsView AllTable of ContentsHow It HappensProgression of SymptomsScreening for MacTel2TreatmentSupplementsVision Aids and SupportResearch Advancements
Table of ContentsView All
View All
Table of Contents
How It Happens
Progression of Symptoms
Screening for MacTel2
Treatment
Supplements
Vision Aids and Support
Research Advancements
Macular telangiectasiatype 2 (MacTel2) is a rare eye condition that causes gradually worsening vision loss in both eyes. It can be detected with diagnostic tests that evaluate eye structure. Surgery, steroid injections, and emerging treatments may sometimes help to preserve vision.
MacTel2 is associated with changes in certain blood vessels within the eyes, but the reason some people are prone to the condition is unknown.Vision loss has many potential causes, so getting an accurate diagnosis is a key factor in getting the right treatment.
This article describes MacTel2 and what you can expect if you have this eye disease.
Drazen Zigic / Getty Images
Macular Telangiectasia Type 2: How It Happens
Several changes occur in the eye with MacTel2; extensive changes usually correlate with more significant vision loss.While there are risk factors for MacTel2, it isn’t completely clear why some people develop this condition.
Risk factors include:
Telangiectasiadescribes the overgrowth of tiny blood vessels. They can develop anywhere in the body, including the eyes.
Changes in protein and fat content in the eyes in MacTel2 lead to the damage of blood vessels aroundthe macula, an area in the back of the eye that processes central vision.The macula allows you to see details of what you are looking at.
Eye changes associated with MacTel2 include:
All of these factors can make it difficult to see and can worsen as the disease progresses over time.
Macular Telangiectasia Type 2 and Macular Telangiectasia Type 1The differences intwo types of macular telangiectasiainclude:Macular telangiectasia type 1usually affects one eye, begins in childhood, and is associated with aneurysms (outpouching of blood vessels) in the eye.Macular telangiectasia type 2affects both eyes, begins during adulthood, and is associated with excess blood vessel formation around the macula.
Macular Telangiectasia Type 2 and Macular Telangiectasia Type 1
The differences intwo types of macular telangiectasiainclude:Macular telangiectasia type 1usually affects one eye, begins in childhood, and is associated with aneurysms (outpouching of blood vessels) in the eye.Macular telangiectasia type 2affects both eyes, begins during adulthood, and is associated with excess blood vessel formation around the macula.
The differences intwo types of macular telangiectasiainclude:
Progression of MacTel2 Symptoms
The symptoms of MacTel2 involve gradual loss of vision. Sometimes, MacTel2 doesn’t cause symptoms in the early stages.
Symptoms can include:
As the condition worsens, it can affect your ability to read or drive. You might begin to have difficulty with day-to-day activities, like seeing the hands on a clock or recognizing people. Getting treatment and using vision aids can help you adapt and see more clearly.
A From VerywellPatients with macular telangiectasia are usually diagnosed at an annual exam. They are usually asymptomatic at the time of diagnosis and need no treatment. Very rare cases end up with a macular hole (a hole in the macula, which is in the retina, the light-sensing tissue in the center of the eye) or retinal atrophy (tissue damage to the retina).—ANDREW GREENBERG, MD, MEDICAL EXPERT BOARD
A From Verywell
Patients with macular telangiectasia are usually diagnosed at an annual exam. They are usually asymptomatic at the time of diagnosis and need no treatment. Very rare cases end up with a macular hole (a hole in the macula, which is in the retina, the light-sensing tissue in the center of the eye) or retinal atrophy (tissue damage to the retina).—ANDREW GREENBERG, MD, MEDICAL EXPERT BOARD
Patients with macular telangiectasia are usually diagnosed at an annual exam. They are usually asymptomatic at the time of diagnosis and need no treatment. Very rare cases end up with a macular hole (a hole in the macula, which is in the retina, the light-sensing tissue in the center of the eye) or retinal atrophy (tissue damage to the retina).
—ANDREW GREENBERG, MD, MEDICAL EXPERT BOARD
An eye exammay detect vision loss or identify changes in your macula. Several tests can help diagnose MacTel2, and you may need this testing if you have risk factors or symptoms of MacTel2.
Tests you might need include:
Diagnostic testing can help identify whether you have MacTel2 and assess disease progression or stability.If you start treatment, your healthcare providers can follow your condition with diagnostic testing to determine how well the treatment is working.
If your condition is mild or you haven’t started treatment, it’s important that your healthcare providers monitor it with diagnostic tests to determine whether it is getting worse and whether you need to begin treatment.
How Is Macular Degeneration Different From Macular Telangiectasia?
Treatment to Manage MacTel2
Usually, MacTel2 progresses very slowly and often it is not treated.In some cases, steroid injections can be used to reduce swelling or inflammation in the eye.
The most well-established treatment option is eye surgery. Several different procedures can be used to treat MacTel2, but surgery is not necessarily a suitable option for everyone who has this condition.
Procedures that have been used fortreating MacTel2include:
Several studies have examined the effectiveness of dietary supplements for treating MacTel2, with inconsistent results. Supplements used include lutein, meso-zeaxanthin, andzeaxanthinsupplements, which might contribute to a healthy macular structure.
Very small studies have shown inconsistent improvement of vision and a possible risk of side effects that could affect vision.You can consider speaking with your eye doctor to see if any supplements might be recommended.
Living with vision losscan pose many serious challenges affecting your daily life. You will need to work with healthcare professionals who can offer you recommendations regarding vision correction.
Your healthcare team will also give you practical tips for living with vision loss. The recommendations will depend on the severity of your vision loss and your lifestyle.
Options that you might consider may include:
Discuss these and other options with your healthcare providers to find a vision aid that’s right for you.
MacTel2 Research Advancements
Research is shedding light on potential treatment options that could improve vision or prevent worsening of vision for people who have MacTel2.
Intravitreal (injected into the eye) anti-vascular endothelial growth factor (anti-VEGF) medications are used to prevent blood vessel overgrowth for other vascular eye diseases. They are also being studied as potential treatments for MacTel2. Preliminary clinical trials using injections of anti-VEGF have shown some promise in treating MacTel2, and research is still ongoing.
Implantation of ciliary neurotrophic factor (CNTF) is another area of ongoing research that is showing potential benefits. This is a substance that may promote the growth and repair of cells in the macula.
Some of the research trials involving anti-VEGF or CNTF have indicated short-term improvements, but haven’t shown sustained benefits, although it maybe too soon to assess long-term outcomes.
Summary
One cause of vision loss, MacTel2, is a rare, progressive degenerative eye condition that causes slowly worsening vision loss over years. It affects both eyes and is associated with overgrowth of blood vessels near the macula, swelling around the macula, and loss of macular cells.
There are some risk factors, including family history, diabetes, and hypertension, but MacTel2 can develop without any risk factors.
Some evidence supports steroid injections or certain supplements to slow vision loss, but surgery is the most well-established treatment for advanced MacTel2. New and emerging treatments currently under investigation in research trials include therapies known to stop blood vessel overgrowth or help heal the macula.
Early diagnosis is important because this condition can worsen and lead to severe vision loss. It’s important to have routine eye exams to detect and treat any eye problems early. See a healthcare provider if you have concerns about your vision or your eyes.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Park JG, Adrean SD, Begaj T, et al.Surgical management of full-thickness macular holes in macular telangiectasia type 2: a global multicenter study.Ophthalmology.2024;131(1):66-77. doi:10.1016/j.ophtha.2023.08.025Kedarisetti KC, Narayanan R, Stewart MW, Reddy Gurram N, Khanani AM.Macular telangiectasia type 2: a comprehensive review.Clin Ophthalmol.2022;16:3297-3309. doi:10.2147/OPTH.S373538Pauleikhoff D, Pauleikhoff L, Chew EY.Imaging endpoints for clinical trials in MacTel type 2.Eye (Lond). 2022;36(2):284-293. doi:10.1038/s41433-021-01723-7Çoban Karataş M, Yılmaz G, Yüce Sezen A, Sarıtürk Ç.Clinical features of untreated type 2 macular telangiectasia and efficacy of anti-vascular endothelial growth factor therapy in macular neovascularization.Turk J Ophthalmol.2022;52(1):45-49. doi:10.4274/tjo.galenos.2021.75608American Academy of Ophthalmology.What is macular telangiectasia?Sharief S, Venkatesh R, Mangla R, Chhablani J.Timing of ocular examination and retinal imaging for the diagnosis of type 2 macular telangiectasia (MacTel).Eur J Ophthalmol.2023;33(6):NP79-NP81. doi:10.1177/11206721231158141Wu Y, Egan C, Olvera-Barrios A, Scheppke L, et al.Developing a continuous severity scale for macular telangiectasia type 2 using deep learning and implications for disease grading.Ophthalmology.2024;131(2):219-226. doi:10.1016/j.ophtha.2023.09.016Tan AC, Balaratnasingam C, Yannuzzi LA.Treatment of macular telangiectasia type 2 with carotenoid supplements containing meso-zeaxanthin: a pilot study.Ophthalmic Surg Lasers Imaging Retina. 2016;47(6):528-35. doi:10.3928/23258160-20160601-04Choi RY, Gorusupudi A, Wegner K, Sharifzadeh M, Gellermann W, Bernstein PS.Macular pigment distribution responses to high-dose zeaxanthin supplementation in patients with macular telangiectasia type 2.Retina. 2017;37(12):2238-2247. doi:10.1097/IAE.0000000000001450
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Park JG, Adrean SD, Begaj T, et al.Surgical management of full-thickness macular holes in macular telangiectasia type 2: a global multicenter study.Ophthalmology.2024;131(1):66-77. doi:10.1016/j.ophtha.2023.08.025Kedarisetti KC, Narayanan R, Stewart MW, Reddy Gurram N, Khanani AM.Macular telangiectasia type 2: a comprehensive review.Clin Ophthalmol.2022;16:3297-3309. doi:10.2147/OPTH.S373538Pauleikhoff D, Pauleikhoff L, Chew EY.Imaging endpoints for clinical trials in MacTel type 2.Eye (Lond). 2022;36(2):284-293. doi:10.1038/s41433-021-01723-7Çoban Karataş M, Yılmaz G, Yüce Sezen A, Sarıtürk Ç.Clinical features of untreated type 2 macular telangiectasia and efficacy of anti-vascular endothelial growth factor therapy in macular neovascularization.Turk J Ophthalmol.2022;52(1):45-49. doi:10.4274/tjo.galenos.2021.75608American Academy of Ophthalmology.What is macular telangiectasia?Sharief S, Venkatesh R, Mangla R, Chhablani J.Timing of ocular examination and retinal imaging for the diagnosis of type 2 macular telangiectasia (MacTel).Eur J Ophthalmol.2023;33(6):NP79-NP81. doi:10.1177/11206721231158141Wu Y, Egan C, Olvera-Barrios A, Scheppke L, et al.Developing a continuous severity scale for macular telangiectasia type 2 using deep learning and implications for disease grading.Ophthalmology.2024;131(2):219-226. doi:10.1016/j.ophtha.2023.09.016Tan AC, Balaratnasingam C, Yannuzzi LA.Treatment of macular telangiectasia type 2 with carotenoid supplements containing meso-zeaxanthin: a pilot study.Ophthalmic Surg Lasers Imaging Retina. 2016;47(6):528-35. doi:10.3928/23258160-20160601-04Choi RY, Gorusupudi A, Wegner K, Sharifzadeh M, Gellermann W, Bernstein PS.Macular pigment distribution responses to high-dose zeaxanthin supplementation in patients with macular telangiectasia type 2.Retina. 2017;37(12):2238-2247. doi:10.1097/IAE.0000000000001450
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Park JG, Adrean SD, Begaj T, et al.Surgical management of full-thickness macular holes in macular telangiectasia type 2: a global multicenter study.Ophthalmology.2024;131(1):66-77. doi:10.1016/j.ophtha.2023.08.025Kedarisetti KC, Narayanan R, Stewart MW, Reddy Gurram N, Khanani AM.Macular telangiectasia type 2: a comprehensive review.Clin Ophthalmol.2022;16:3297-3309. doi:10.2147/OPTH.S373538Pauleikhoff D, Pauleikhoff L, Chew EY.Imaging endpoints for clinical trials in MacTel type 2.Eye (Lond). 2022;36(2):284-293. doi:10.1038/s41433-021-01723-7Çoban Karataş M, Yılmaz G, Yüce Sezen A, Sarıtürk Ç.Clinical features of untreated type 2 macular telangiectasia and efficacy of anti-vascular endothelial growth factor therapy in macular neovascularization.Turk J Ophthalmol.2022;52(1):45-49. doi:10.4274/tjo.galenos.2021.75608American Academy of Ophthalmology.What is macular telangiectasia?Sharief S, Venkatesh R, Mangla R, Chhablani J.Timing of ocular examination and retinal imaging for the diagnosis of type 2 macular telangiectasia (MacTel).Eur J Ophthalmol.2023;33(6):NP79-NP81. doi:10.1177/11206721231158141Wu Y, Egan C, Olvera-Barrios A, Scheppke L, et al.Developing a continuous severity scale for macular telangiectasia type 2 using deep learning and implications for disease grading.Ophthalmology.2024;131(2):219-226. doi:10.1016/j.ophtha.2023.09.016Tan AC, Balaratnasingam C, Yannuzzi LA.Treatment of macular telangiectasia type 2 with carotenoid supplements containing meso-zeaxanthin: a pilot study.Ophthalmic Surg Lasers Imaging Retina. 2016;47(6):528-35. doi:10.3928/23258160-20160601-04Choi RY, Gorusupudi A, Wegner K, Sharifzadeh M, Gellermann W, Bernstein PS.Macular pigment distribution responses to high-dose zeaxanthin supplementation in patients with macular telangiectasia type 2.Retina. 2017;37(12):2238-2247. doi:10.1097/IAE.0000000000001450
Park JG, Adrean SD, Begaj T, et al.Surgical management of full-thickness macular holes in macular telangiectasia type 2: a global multicenter study.Ophthalmology.2024;131(1):66-77. doi:10.1016/j.ophtha.2023.08.025
Kedarisetti KC, Narayanan R, Stewart MW, Reddy Gurram N, Khanani AM.Macular telangiectasia type 2: a comprehensive review.Clin Ophthalmol.2022;16:3297-3309. doi:10.2147/OPTH.S373538
Pauleikhoff D, Pauleikhoff L, Chew EY.Imaging endpoints for clinical trials in MacTel type 2.Eye (Lond). 2022;36(2):284-293. doi:10.1038/s41433-021-01723-7
Çoban Karataş M, Yılmaz G, Yüce Sezen A, Sarıtürk Ç.Clinical features of untreated type 2 macular telangiectasia and efficacy of anti-vascular endothelial growth factor therapy in macular neovascularization.Turk J Ophthalmol.2022;52(1):45-49. doi:10.4274/tjo.galenos.2021.75608
American Academy of Ophthalmology.What is macular telangiectasia?
Sharief S, Venkatesh R, Mangla R, Chhablani J.Timing of ocular examination and retinal imaging for the diagnosis of type 2 macular telangiectasia (MacTel).Eur J Ophthalmol.2023;33(6):NP79-NP81. doi:10.1177/11206721231158141
Wu Y, Egan C, Olvera-Barrios A, Scheppke L, et al.Developing a continuous severity scale for macular telangiectasia type 2 using deep learning and implications for disease grading.Ophthalmology.2024;131(2):219-226. doi:10.1016/j.ophtha.2023.09.016
Tan AC, Balaratnasingam C, Yannuzzi LA.Treatment of macular telangiectasia type 2 with carotenoid supplements containing meso-zeaxanthin: a pilot study.Ophthalmic Surg Lasers Imaging Retina. 2016;47(6):528-35. doi:10.3928/23258160-20160601-04
Choi RY, Gorusupudi A, Wegner K, Sharifzadeh M, Gellermann W, Bernstein PS.Macular pigment distribution responses to high-dose zeaxanthin supplementation in patients with macular telangiectasia type 2.Retina. 2017;37(12):2238-2247. doi:10.1097/IAE.0000000000001450
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