case_images: PMC10890713_01
case_images: Membranous glomerulonephrits. Glomerulus with thickened basement membranes (1A - PAS stain 400x). Membranous and granular staining for IgG4 (1B- IgG4 400x).
case_images: cureus-0016-00000052867-i01.jpg
case_images: PMC10890713_01_cureus-0016-00000052867-i01.jpg
case_images: FIG1
case_images: Glomeruli had thickened glomerular basement membranes; immunofluorescence showed membranous and granular immunoglobulin G (IgG) deposits with IgG4 expression (Figure 1). 
case_images: Optical coherence tomography scans of the left eye at the initial presentation (A) and three months after rituximab discontinuation (B).
case_images: cureus-0016-00000052867-i02.jpg
case_images: PMC10890713_01_cureus-0016-00000052867-i02.jpg
case_images: FIG2
case_images: Urgent ophthalmological evaluation confirmed decreased visual acuity (right eye 8/10, left eye 6/10), central neurosensory detachment, and intraretinal and subretinal fluid areas bilaterally, consistent with CME on OCT (Figures 2A-3A). A retinal ophthalmology follow-up was scheduled within three months, during which the patient showed substantial improvement in visual acuity (right eye 10/10, left eye 8/10), along with improvement in OCT; the macular edema was more circumscribed, with only a thin subretinal fluid lamella (Figures 2B-3B). 
case_images: Optical coherence tomography scans of the right eye at the initial presentation (A) and three months after rituximab discontinuation (B).
case_images: cureus-0016-00000052867-i03.jpg
case_images: PMC10890713_01_cureus-0016-00000052867-i03.jpg
case_images: FIG3
case_images: Urgent ophthalmological evaluation confirmed decreased visual acuity (right eye 8/10, left eye 6/10), central neurosensory detachment, and intraretinal and subretinal fluid areas bilaterally, consistent with CME on OCT (Figures 2A-3A). A retinal ophthalmology follow-up was scheduled within three months, during which the patient showed substantial improvement in visual acuity (right eye 10/10, left eye 8/10), along with improvement in OCT; the macular edema was more circumscribed, with only a thin subretinal fluid lamella (Figures 2B-3B). 