{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:47:51Z","timestamp":1786121271150,"version":"build-2736575974"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Primary vitreoretinal lymphoma (PVRL) is a rare intraocular malignancy, often masquerading as chronic uveitis, which poses significant diagnostic and therapeutic challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 55-year-old male with 1\u202fyear of progressive bilateral vision loss was initially misdiagnosed as having bilateral uveitis and received ineffective corticosteroid therapy at an outside medical center. Subsequent diagnostic vitrectomy of the right eye confirmed bilateral PVRL. He received intravitreal methotrexate (MTX) injections for treatment but developed MTX-induced toxic keratitis and progressive cataract, necessitating discontinuation of MTX. He was transitioned to systemic therapy with anti-CD20 monoclonal antibody (discontinued due to pulmonary infection) plus oral pomalidomide and orelabrutinib, which achieved complete clearance of vitreous disease, normalization of aqueous IL-10, and sustained clinical remission without significant hematologic or cardiac toxicities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Precise diagnosis and individualized treatment regimens are required for the therapy of PVRL. Besides, the orelabrutinib\u2013pomalidomide combination represents a promising, well-tolerated targeted and chemo free therapy strategy for PVRL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1806373","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T04:21:51Z","timestamp":1786076511000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Orelabrutinib in combination with pomalidomide for the successful treatment of primary vitreoretinal lymphoma: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Yanli","family":"Lai","sequence":"first","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Ningbo University","place":["Ningbo, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengyao","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The First Affiliated Hospital of Ningbo University","place":["Ningbo, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lixia","family":"Sheng","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Ningbo University","place":["Ningbo, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guifang","family":"Ouyang","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Ningbo University","place":["Ningbo, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The First Affiliated Hospital of Ningbo University","place":["Ningbo, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ningning","family":"Wu","sequence":"additional","affiliation":[{"name":"Stem Cell Laboratory, Department of Hematology, The First Affiliated Hospital of Ningbo University","place":["Ningbo, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shasha","family":"You","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Ningbo University","place":["Ningbo, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1589","DOI":"10.1634\/theoncologist.2011-0210","article-title":"Primary vitreoretinal lymphoma: a report from an international primary central nervous system lymphoma collaborative group symposium","volume":"16","author":"Chan","year":"2011","journal-title":"Oncologist"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1080\/09273948.2021.1878233","article-title":"Consensus recommendations for the diagnosis of vitreoretinal lymphoma","volume":"29","author":"Carbonell","year":"2021","journal-title":"Ocul Immunol Inflamm"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"808511","DOI":"10.3389\/fonc.2022.808511","article-title":"Clinical features, diagnosis, management and prognosis of primary intraocular lymphoma","volume":"12","author":"Zhao","year":"2022","journal-title":"Front Oncol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1186\/s12886-023-02781-z","article-title":"Correction: Epidemiology and survival outcomes of patients with primary intraocular lymphoma: a population-based analysis","volume":"23","author":"He","year":"2023","journal-title":"BMC Ophthalmol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1007\/s00277-014-2212-z","article-title":"Prognostic impact of intraocular involvement in primary CNS lymphoma: experience from the G-PCNSL-SG1 trial","volume":"94","author":"Kreher","year":"2015","journal-title":"Ann Hematol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1016\/j.survophthal.2023.12.001","article-title":"Diagnostic methods for primary vitreoretinal lymphoma: a systematic review","volume":"69","author":"Huang","year":"2024","journal-title":"Surv Ophthalmol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.cca.2020.12.035","article-title":"The diagnostic value of IL-10 and IL-6 level in vitreous fluid and aqueous humor for vitreoretinal lymphoma","volume":"515","author":"Chen","year":"2021","journal-title":"Clin Chim Acta"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/j.ajo.2023.03.010","article-title":"Longitudinal analysis of ocular manifestation and interleukin during intravitreal treatment of vitreoretinal lymphoma with methotrexate","volume":"251","author":"Gu","year":"2023","journal-title":"Am J Ophthalmol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1182\/blood-2015-01-620518","article-title":"High frequency of MYD88 mutations in vitreoretinal B-cell lymphoma: a valuable tool to improve diagnostic yield of vitreous aspirates","volume":"126","author":"Bonzheim","year":"2015","journal-title":"Blood"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1098","DOI":"10.1001\/jamaophthalmol.2018.2887","article-title":"Potential diagnosis of vitreoretinal lymphoma by detection of MYD88 mutation in aqueous humor with ultrasensitive droplet digital polymerase chain reaction","volume":"136","author":"Hiemcke-Jiwa","year":"2018","journal-title":"JAMA Ophthalmol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1186\/s13045-024-01606-w","article-title":"Phase IB part of LOC-R01, a LOC network non-comparative randomized phase IB\/II study testing R-MPV in combination with escalating doses of lenalidomide or ibrutinib for newly diagnosed primary central nervous system lymphoma (PCNSL) patients","volume":"17","author":"Alcantara","year":"2024","journal-title":"J Hematol Oncol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1186\/s13045-024-01620-y","article-title":"Correction: phase IB part of LOC-R01, a LOC network non-comparative randomized phase IB\/II study testing R-MPV in combination with escalating doses of lenalidomide or ibrutinib for newly diagnosed primary central nervous system lymphoma (PCNSL) patients","volume":"17","author":"Alcantara","year":"2024","journal-title":"J Hematol Oncol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"101053","DOI":"10.1016\/j.preteyeres.2022.101053","article-title":"Challenges in the diagnosis and management of vitreoretinal lymphoma\u2014clinical and basic approaches","volume":"90","author":"Takase","year":"2022","journal-title":"Prog Retin Eye Res"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1519","DOI":"10.1182\/blood.2020008235","article-title":"Primary vitreoretinal lymphoma: a diagnostic and management challenge","volume":"138","author":"Soussain","year":"2021","journal-title":"Blood"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1186\/s12886-020-01464-3","article-title":"Reduced frequency of intravitreal methotrexate injection lowers the risk of keratopathy in vitreoretinal lymphoma patients","volume":"20","author":"Zhou","year":"2020","journal-title":"BMC Ophthalmol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s12886-019-1300-1","article-title":"Longitudinal observation of OCT imaging is a valuable tool to monitor primary vitreoretinal lymphoma treated with intravitreal injections of methotrexate","volume":"20","author":"Zhao","year":"2020","journal-title":"BMC Ophthalmol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1136\/bjo.2007.127928","article-title":"Intravitreal methotrexate for treating vitreoretinal lymphoma: 10 years of experience","volume":"92","author":"Frenkel","year":"2008","journal-title":"Br J Ophthalmol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"951362","DOI":"10.3389\/fonc.2022.951362","article-title":"Case report: intravitreal methotrexate in intraocular acute lymphoblastic leukemia","volume":"12","author":"Pederzolli","year":"2022","journal-title":"Front Oncol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1458","DOI":"10.1111\/cas.13012","article-title":"High-dose methotrexate following intravitreal methotrexate administration in preventing central nervous system involvement of primary intraocular lymphoma","volume":"107","author":"Akiyama","year":"2016","journal-title":"Cancer Sci"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1186\/s13045-022-01353-w","article-title":"BTK inhibitors in the treatment of hematological malignancies and inflammatory diseases: mechanisms and clinical studies","volume":"15","author":"Alu","year":"2022","journal-title":"J Hematol Oncol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"101682","DOI":"10.1016\/j.eclinm.2022.101682","article-title":"Evaluation of orelabrutinib monotherapy in patients with relapsed or refractory Waldenstr\u00f6m's macroglobulinemia in a single-arm, multicenter, open-label, phase 2 study","volume":"52","author":"Cao","year":"2022","journal-title":"EClinicalMedicine"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"e7005","DOI":"10.1002\/cam4.7005","article-title":"A single-centre, real-world study of BTK inhibitors for the initial treatment of MYD88(Mut) \/CD79B(Mut) diffuse large B-cell lymphoma","volume":"13","author":"Deng","year":"2024","journal-title":"Cancer Med"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1016\/S1470-2045(22)00019-5","article-title":"Isatuximab plus pomalidomide and low-dose dexamethasone versus pomalidomide and low-dose dexamethasone in patients with relapsed and refractory multiple myeloma (ICARIA-MM): follow-up analysis of a randomised, phase 3 study","volume":"23","author":"Richardson","year":"2022","journal-title":"Lancet Oncol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e935","DOI":"10.1016\/S2352-3026(25)00288-1","article-title":"Fixed-duration ibrutinib-venetoclax with MRD-guided ibrutinib-obinutuzumab intensification in first-line chronic lymphocytic leukaemia (HOVON 158\/NEXT STEP): primary analysis of a multicentre, open-label, phase 2 trial","volume":"12","author":"Kater","year":"2025","journal-title":"Lancet Haematol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1038\/s41375-025-02787-0","article-title":"Noninvasive genotyping and early disease dynamics demonstrate the efficacy of ibrutinib in combination with immunochemotherapy in patients with mantle cell lymphoma treated in the TRIANGLE trial","volume":"40","author":"Khouja","year":"2026","journal-title":"Leukemia"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"e70246","DOI":"10.1002\/hem3.70246","article-title":"Overall survival outcomes with first-line continuous ibrutinib and fixed-duration ibrutinib-venetoclax treatments in patients with chronic lymphocytic leukemia: comparison with an age-matched European population","volume":"9","author":"Ghia","year":"2025","journal-title":"Hema"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1800529","DOI":"10.3389\/fonc.2026.1800529","article-title":"Orelabrutinib and rituximab regimen combined with intravitreal methotrexate for treatment of primary vitreoretinal lymphoma: a case report and literature review","volume":"16","author":"Li","year":"2026","journal-title":"Front Oncol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1806373\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T04:21:51Z","timestamp":1786076511000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1806373\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,7]]},"references-count":27,"alternative-id":["10.3389\/fmed.2026.1806373"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1806373","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,7]]},"article-number":"1806373"}}