The Retina TL;DR with Dr. Weng: Marking a MacTel milestone with Thomas M. Aaberg Jr., MD

In this episode of The Retina TL;DR with Dr. Weng, powered by Modern Retina, host Christina Y. Weng, MD, MBA, FASRS, professor and the Alice R. McPherson Retina Research Foundation Chair in Ophthalmology at Baylor College of Medicine in Houston, Texas, welcomes Thomas M. Aaberg Jr., MD, for a discussion on revakinagene taroretcel-lwey (Encelto; Neurotech), the first FDA-approved treatment for adults with macular telangiectasia type 2 (MacTel type 2). Aaberg is founder of Retina Specialists of Michigan and chief medical officer at Neurotech Pharmaceuticals.

Aaberg cut straight to his “TL;DR” (“too long; didn’t read”): the treatment is a first-in-class cell-based gene therapy designed to produce ciliary neurotrophic factor (CNTF), a known neuroprotectant, for adults with MacTel type 2.

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An inspiring origin story

Aaberg noted that beyond being a first-in-class therapy, the treatment carries an inspiring backstory. In 2004, the Lowy family—motivated by a family member’s MacTel diagnosis—established the Lowy Medical Research Institute to understand and develop a treatment for the disease.¹ In 2010, the Lowy Family Group approached Neurotech to develop NT-501, now the approved treatment, and became Neurotech’s major shareholder in 2016.

How it works—and how long it lasts

Aaberg described the implant as having two components: an engine of genetically modified RPE cells that produce CNTF, and a chassis—a semipermeable hollow fiber membrane that protects the cells from the host immune system while allowing CNTF to diffuse into the vitreous. The implant is inserted through a 3 mm pars plana incision and fixated to the scleral wall. Published data from 49 explanted devices collected over 20 years showed steady CNTF production for up to 14.5 years, with cells histologically identical to pre-implant cells, he noted. “We really don’t know how long these things can last,” Aaberg said, “but we have evidence to suggest it lasts for at least 14 and a half years.”

Clinical results, safety, and market reception

In the registration trials, treated patients showed a 55% reduction in ellipsoid zone loss in NTMT-03C and a 30% reduction in NTMT-03B—both statistically significant. (Clarification at 04:51: The 55% reduction in ellipsoid zone loss was observed in the NTMT-03A study.)

A post-hoc pooled analysis also showed reductions in aggregate retinal sensitivity loss and reading speed loss.² Earlier treatment—defined by smaller ellipsoid zone area breaks—was associated with a 2.5 times greater odds of high treatment response; patients with diabetes showed three times greater odds. Most adverse events were mild to moderate and surgery-related; two CNTF-specific reactions to discuss with patients are delayed dark adaptation (approximately 20% of phase 3 patients) and miosis (approximately 15%), neither of which led to explantation requests.

The treatment received FDA approval in March 2025 and its J code (J3403) in October 2025.³ The largest national plans now provide favorable coverage supported by 88 medical policies covering approximately 200 million lives, he noted. Aaberg reported his own patients are doing “incredibly well,” with many requesting treatment of their second eye shortly after the first.

Additional resources

For retina specialists and patients seeking additional information, Aaberg encouraged visiting www.encelto.com.

Christina Y. Weng, MD, MBA, FASRS, is professor and the Alice R. McPherson Retina Research Foundation Chair in Ophthalmology, and fellowship program director, vitreoretinal diseases and surgery, with Baylor College of Medicine in Houston, Texas. Weng has no relevant disclosures.

Thomas M. Aaberg Jr., MD, is founder of Retina Specialists of Michigan and chief medical officer at Neurotech.

The content of The Retina TL;DR with Dr. Weng video podcast series, powered by Modern Retina, is editorially independent.

References

1. FDA approves ENCELTO, a first-of-its-kind eye implant that slows vision loss in rare eye disease. News release. Scripps Research. June 4, 2025. Accessed September 9, 2026. https://www.scripps.edu/news-events/news/20250604-friedlander-encelnto/

2. Goldberg RA, Manning DC, Yankey J, et al. Pooled analyses of anatomic and visual function data of revakinagene taroretcel-lwey in participants with macular telangiectasia type 2. Ophthalmol Retina. Published online July 20, 2026. doi:10.1016/j.oret.2026.07.005

3. Neurotech Pharmaceuticals, Inc. Neurotech granted permanent J-code (J3403) for ENCELTO (revakinagene taroretcel-lwey), effective October 1, 2025. Published September 29, 2025. Accessed September 9, 2026. https://www.neurotechpharmaceuticals.com/wp-content/uploads/Neurotech_Press-Release_Permanent-J-Code_29SEPT2025.pdf