Background/aims To investigate the effectiveness of isolated subtenon triamcinolone acetonide injection (STI) as a primary treatment in eyes with acute Vogt–Koyanagi–Harada (VKH) disease.

Design Retrospective, observational, cross-sectional study.

Methods The data from 27 eyes in 14 patients with acute VKH treated with STI therapy were analysed retrospectively. The time course change in ocular inflammation, best corrected visual acuity (BCVA) and numbers of recurrences were examined.

Results STI led to prompt improvement of BCVA within a week after the primary treatment. After completing therapy, patients with VKH had improved BCVA compared with baseline. In six eyes of three patients (22.2%) treated with STI, ocular inflammation was refractory, or VKH was recurrent despite the treatment. There was significant difference between groups with and without recurrences of inflammation in the frequency of headaches before treatment. In the present study, 21 eyes of 11 patients (77.8%) achieved complete resolution of VKH without recurrence after STI therapy alone.

Conclusions This study demonstrated that isolated STI therapy is a useful, minimally invasive, primary treatment option for patients with acute VKH without systemic disorders.