{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T01:44:22Z","timestamp":1770083062897,"version":"3.49.0"},"reference-count":132,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Hydroxychloroquine (HCQ) is widely used in the treatment of autoimmune rheumatologic diseases due to its immunomodulatory and anti-inflammatory properties. However, long-term HCQ therapy carries a risk of irreversible retinal toxicity caused by drug accumulation in the retinal pigment epithelium. The early identification of preclinical retinal changes is essential to prevent permanent visual impairment. Optical coherence tomography (OCT) and OCT-angiography (OCT-A) have emerged as key imaging modalities for the detection of structural and microvascular biomarkers of HCQ retinopathy. A narrative review of the literature was conducted using the PubMed database, focusing on studies published between January 2017 and February 2025. Search terms included \u201chydroxychloroquine\u201d and \u201coptical coherence tomography.\u201d Eligible studies evaluated HCQ-related retinal toxicity using OCT and\/or OCT-A in human subjects. Data were extracted regarding study population characteristics, treatment duration, cumulative HCQ dose, daily dose normalized to real body weight, and reported imaging findings. Results: We identified 223 scientific papers of which 88 studies met the inclusion criteria. Structural OCT parameters\u2014particularly alterations in the ellipsoid zone, outer nuclear layer, and retinal pigment epithelium\u2014were consistently associated with early HCQ toxicity, often preceding functional impairment. OCT-A studies demonstrated microvascular alterations, including reduced vessel density and foveal avascular zone enlargement, though interpretation may be confounded by underlying autoimmune-disease-related vasculopathy. Conclusions: HCQ retinopathy is a potentially vision-threatening condition associated with the cumulative dose, treatment duration, and patient-specific risk factors. OCT and OCT-A provide complementary structural and vascular biomarkers that aid in the detection of subclinical retinal toxicity. The integration of quantitative and automated OCT-derived metrics may improve screening strategies, facilitate early diagnosis, and support personalized care in patients receiving long-term HCQ therapy.<\/jats:p>","DOI":"10.3390\/diagnostics16030463","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T14:12:46Z","timestamp":1770041566000},"page":"463","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Optical Coherence Tomography and Angiography in Hydroxychloroquine Retinopathy: A Narrative Review"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5031-0102","authenticated-orcid":false,"given":"Alexandra Lori","family":"Donica","sequence":"first","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, University Street, No. 16, 700115 Iasi, Romania"},{"name":"2nd Rheumatology Department, Clinical Rehabilitation Hospital, 700661 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8814-3932","authenticated-orcid":false,"given":"Vlad Constantin","family":"Donica","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, University Street, No. 16, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8395-1808","authenticated-orcid":false,"given":"Mara","family":"Russu","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, University Street, No. 16, 700115 Iasi, Romania"},{"name":"2nd Rheumatology Department, Clinical Rehabilitation Hospital, 700661 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2516-1058","authenticated-orcid":false,"given":"Vladia","family":"L\u0103pu\u0219te","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, University Street, No. 16, 700115 Iasi, Romania"},{"name":"2nd Rheumatology Department, Clinical Rehabilitation Hospital, 700661 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2828-7758","authenticated-orcid":false,"given":"Cristina","family":"Pom\u00eerleanu","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, University Street, No. 16, 700115 Iasi, Romania"},{"name":"2nd Rheumatology Department, Clinical Rehabilitation Hospital, 700661 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9542-7714","authenticated-orcid":false,"given":"Camelia Margareta","family":"Bogd\u0103nici","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, University Street, No. 16, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anisia Iuliana","family":"Alexa","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, University Street, No. 16, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0516-9262","authenticated-orcid":false,"given":"C\u0103lina Anda","family":"Sandu","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, University Street, No. 16, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioana M\u0103d\u0103lina","family":"Bilha","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, University Street, No. 16, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1777-8121","authenticated-orcid":false,"given":"Codrina","family":"Ancu\u021ba","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, University Street, No. 16, 700115 Iasi, Romania"},{"name":"2nd Rheumatology Department, Clinical Rehabilitation Hospital, 700661 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2221","DOI":"10.1007\/s00417-023-06023-2","article-title":"Application of optical coherence tomography angiography for microvascular changes in patients treated with hydroxychloroquine: A systematic review and meta-analysis","volume":"261","author":"Ferreira","year":"2023","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Yusuf, I.H., Issa, P.C., and Ahn, S.J. (2023). Hydroxychloroquine-induced Retinal Toxicity. Front. 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