Macular Telangiectasia Type 2 (MacTel2) and Vision Loss
A Progressive Type of Vision Loss
Medically reviewed by Andrew Greenberg, MDMedically reviewed by Andrew Greenberg, MD
Macular telangiectasia type 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:
Advancing age
Hypertension (high blood pressure)
Family history of MacTel2
Certain genetic factors
Telangiectasia describes 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 around the 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:
Small blood vessels in the eye widen and leak
New blood vessels (telangiectasias) form around the macula
Thickening or scarring of the macula
Macular tissue may become thinner, with a loss of photoreceptor cells (the cells that detect light)
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 1
The differences in two types of macular telangiectasia include:
Macular telangiectasia type 1 usually affects one eye, begins in childhood, and is associated with aneurysms (outpouching of blood vessels) in the eye.
Macular telangiectasia type 2 affects both eyes, begins during adulthood, and is associated with excess blood vessel formation around the macula.
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:
Blurry vision from both eyes
Trouble reading and seeing details
Difficulty recognizing objects, especially if they look similar to each other
Since MacTel2 specifically affects central vision, you can often see better by looking at things from different angles as you move your eyes and head. You might not notice the vision loss right away because it is possible to compensate for loss of central vision.
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.
Screening for MacTel2
An eye exam may 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:
Vision exam: During this exam, your eye doctor will assess your vision by asking you to read a distance vision chart and a close-up vision chart. This test may also include an assessment of your peripheral vision and central vision.
Eye exam: Your eye doctor will look into your eyes using an ophthalmoscope and equipment to visualize your macula, your retina (the light-sensing area around your macula), and the blood vessels in your eye.
Optical coherence tomography (OCT): This noninvasive imaging test takes pictures of the back of your eye.
OCT angiography: This imaging test takes pictures of the blood vessels in your eye.
Fluorescein angiography: This imaging test involves injecting fluorescein dye to take pictures of the blood vessels in your eye.
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?
Macular degeneration is a very common cause of adult vision loss. It is age-related and caused by protein deposits under the macula that lead to thinning and degeneration of macular cells.
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 for treating MacTel2 include:
Laser surgery: May help seal a hole in the macula
Internal limiting membrane (ILM) peeling: Removal of scar tissue from the macula
Autologous retinal transplantations: Use of a person’s own retinal tissue to repair a hole in the macula
Subretinal bleb: Injection of fluid into the macular hole to seal the hole
Retinotomy: Removal of thick or damaged tissue from the retina
Supplements
Several studies have examined the effectiveness of dietary supplements for treating MacTel2, with inconsistent results. Supplements used include lutein, meso-zeaxanthin, and zeaxanthin supplements, 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.
Vision Aids and Support
Living with vision loss can 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:
Wearing corrective lenses
Adjusting the lighting in your surroundings for optimal vision
Using a cane for safety
Getting tested to see if your vision is adequate for driving
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.
Read the original article on Verywell Health.
