AIM:To discuss the diagnosis of Vogt-Koyanagi-Harada syndrome(VKHS)and evaluate the clinical effect of different corticosteroid therapies.

METHODS: Forty-five patients(90 eyes)from January 2010 to February 2014 with VKHS were enrolled in this retrospective case study. The patients were divided into two groups. Twenty-five patients(50 eyes)in observation group were treated with methylprednisolone(1.0g)for 3 days. Then the methylprednisolone was reduced to 0.5g per day in the fourth and fifth day. Twenty patients(40 eyes)in control group were treated with dexamethasone(12mg)for 5 days. Then 60mg of prednisone were given to all the 45 patients and reduced according to the patients' inflammatory, taken off 5mg every time. When the dose was reduced to 15～20mg, the treatment was sustained for 6mo at least. Then the dose was reduced again till prednisone was taken off. The total course of treatment was more than 9mo. All patients underwent B type ultrasound scan, optical coherence tomography(OCT)and fundus fluorescein angiography(FFA)before and after treatments. The changes were analyzed.

RESULTS: There was no statistical significance on vision between the two groups before treatments. Vision of all patients improved after treatments, and that in observation group(0.44±0.19)were significantly better than that in control group(0.55±0.29)at the fifth day(P<0.05). Fifteen days after treatments, vision in the two groups both improved further, that in observation group(0.32±0.17)were better than that in control group(0.39±0.22)without statistical significance(P>0.05). Thirty days after treatment, vision of the two groups was almost back to normal. According to OCT, 84 eyes(93%)had macular neuroepithelial detachment or serous macular detachment, and height of detachment was 1009.67±319.40 μm in observation group, 1098.13±283.45μm in control group. Five days after treatments, the height of detachment in observation group was 307.79±71.35μm, significantly lower than control group(434.13±88.67μm)(P<0.01). And 15 days after treatments,the subretinal fluid in macular zone was absorbed obviously, the height of detachment was 290.61±52.55μm in observation group and 296.55±61.57μm in control group, the difference was not statistically significant(P>0.05). And 30 days after treatments, the morphology of fovea was almost back to normal. One month after treatments, the FFA results were almost normal, expect 8 eyes had slightly leakage.

CONCLUSION: Large dose of methylprednisolone in early stage can improve the VKH patients' vision and promote the subretinal effusion absorption, which has better clinic effect and less adverse reaction than dexamethasone, is worth spread.