To evaluate the role of previously reported risk factors on developing retinopathy in patients treated with chloroquine (CQ) and hydroxychloroquine (HCQ). Ophthalmologic examination, visual field testing, and spectral domain-optical coherence tomography were performed in 31 patients treated with CQ and HCQ. Toxicity diagnosis was proven by electrophysiological assessment. The risk factors reported by the American Academy of the Ophthalmology (AAO) were compared between patients with (n = 5) and without toxicity (n = 26) findings. Risk score was calculated for each patient. CQ daily overdose per actual body weight was significantly higher in affected patients. There was no statistically significant difference between groups concerning risk score, estimated cumulative dose of CQ, daily dose of HCQ and CQ per lean body weight, daily overdose of CQ per lean body weight and actual body weight (> 3 mg/kg). The cumulative dose of HCQ was significantly higher in non-affected patients. The risk factors reported by the AAO might not be applicable to all CQ- and HCQ-treated patients. Different risk factors not yet reported may play a role in the development of CQ and HCQ retinopathy.