What is known

• Hydroxychloroquine (HCQ) is widely used for autoimmune disorders but is associated with the risk of retinal toxicity.

• Early detection of retinal structural changes due to HCQ toxicity remains challenging, and cumulative HCQ dose as a risk factor has conflicting clinical relevance.

What Is New

• Higher cumulative HCQ doses are significantly associated with thinner outer retinal layers (foveal, parafoveal, and perifoveal regions).

• No significant associations were found between HCQ cumulative dose and inner retinal thickness or age.