Abstract: Objective To analyze the optical coherence tomography（OCT）characteristics of acute Vogt-Koyanagi-Harada disease(VKH) with standard corticosteroid treatment, and to evaluate the possibility of using OCT to monitor the progress and to predict the prognosis in acute and recovering phase of VKH. Design Retrospective case series. Participants 26 eyes of 13 patients with acute-phase VKH disease treated and followed up in out-patient department of Beijing Tongren Hospital between Oct. 2010 and Aug. 2011 were included. Methods All the patients were treated with prednisone 1.5 mg/kg/d for three to seven consecutive days, and then the dose of prednisone was reduced  gradually. Best corrected visual acuity (BCVA) was checked, and HRA-OCT images were obtained at the initial visit and 4 days to 8 months periodically after corticosteroid treatment. Follow-up technique was used to make sure the same scan line in every OCT checkup time. BCVA，retinal morphological characteristics and central retinal thickness(CRT) were analyzed before and after the treatment.  Main Outcome Measures BCVA, retinal morphological characteristics and CRT. Results The mean BCVA at 4-7 days, 1 month, 3 months and 6-8 months after treatment was 0.55±0.24, 0.64±0.20, 0.62±0.15, 0.64±0.14 respectively, improved significantly than that before treatment（0.21±0.13,  F=23.47， P=0.000). The mean BCVA improved significantly in the first 4-7 days, and had little change in 1 month, then kept steady in 3 months. OCT showed serous retinal detachment and destruction in the outer part of neuro-retina in acute-phase of VKH. All of the sub-retinal exudates were absorbed 1 month after systemic corticosteroid treatment. IS/OS reflex recovered in 57.69% of the eyes in 1 to 3 months. The mean CRT was 535.29±287.70 μm before treatment, and 252.33±54.02, 177.25±22.39, 188.25±25.50, 176.43±21.35 μm respectively at 4-7 days, 1 month, 3 months and 6～8 months post-treatment, the difference had statistics significance (F=13.01，P=0.00) . The differences of  CRT between pre-treatment and 4-7 days after treatment, 4-7 days and 1 month after treatment were statistically significant （P=0.010, 0.005 respectively）. The difference among the 1 month and 3 months post-treatment, 6～8 months post-treatment was not significant（P=0.984, 1.000）. The BCVA was significantly inversely correlated with CRT（r=－0.380, P=0.04）. Conclusion OCT may show the progress of neuro-retinal recovery and CRT changes, thus provide a valuable method to monitor the diagnosis and predict the prognosis of VKH. （Ophthalmol CHN, 2012, 21: 344-348）

Key words: Vogt-Koyanagi-Harada disease, optical coherence tomography