be considered in cases of mild paramacular dot and blot hemorrhages and in cases of macular and paramacular retinal pigment epithelium (RPE) hyperplasia where no other cause can be identified. Causes In September 2019, researchers announced, "a combination of genetics, metabolism and biochemistry drives a disease such as MacTel". Treatment The most crucial aspect of treating macular telangiectasia is recognition of the clinical signs. This condition is relatively uncommon: hence, many practitioners may not be familiar with or experienced in diagnosing the disorder. MacTel must be part of the differential in any case of idiopathic paramacular hemorrhage, vasculopathy, macular edema or focal pigment hypertrophy, especially in those patients without a history of retinopathy or contributory systemic disease. Treatment options are limited. Laser therapy may actually enhance vessel ectasia and promote intraretinal fibrosis in these individuals. Monthly injections of VEGF inhibitors have not proven to be effective in non-proliferative MacTel type 2. Ranibizumab (Lucentis) or bevacizumab (Avastin) may reduce vascular leakage, but neural atrophy may still occur in treated eyes. In proliferative stages (neovascularisation), treatment with Anti-VEGF can be helpful. Ciliary neurotrophic factor (CNTF) is believed to have neuroprotective properties and could thus be able to slow down the progression of MacTel type 2. According to the American Academy of Ophthalmology, a novel CNTF implant "is a semipermeable fiber membrane filled with human retinal pigment epithelium cells that secrete ciliary neurotrophic factor". During Phase 2 testing, the implant device was "shown to slow the progression of retinal degeneration compared with participants who received the sham treatment. Based on the positive Phase 2 results, two parallel Phase 3 studies were initiated... enrolling patients in the United States, Australia, and Europe to determine the safety and efficacy... for the treatment of MacTel". In February 2019, the U.S. Food and Drug Administration granted "Fast Track" designation for approval of the device to treat macular telangiectasia type 2. Type 3 "Idiopathic macular telangiectasia type 3 is a rare, acquired, eye disease characterized by progressive visual loss, due to bilateral juxtafoveolar capillary occlusions, capillary telangiectasia, and minimal exudation. It is associated with systemic or cerebral vascular occlusive disease." Terminology Type 3 macular telangiectasia is also called "occlusive idiopathic juxtafoveolar retinal telangiectasis". References Further reading External links (video, 58:08 minutes) Eye diseases Disorders of choroid and retina Visual disturbances and blindness