Purpose <p>To investigate retinal and choroidal optical coherence tomography (OCT) parameters in eyes with acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and their changes during the follow-up.</p> Methods <p>Best corrected visual acuity (BCVA- Snellen), central macular thickness (CMT), central choroidal thickness (CCT), total choroidal area (TCA), and choroidal vascularity index (CVI) and the other clinical findings were recorded at baseline and month 1, month 3, and year 1.</p> Results <p>Twenty-two eyes of 11 patients were included in this study. The mean follow-up period was 18.3 ± 11.9&#xa0;months. While the mean BCVA value was 0.54 at the initial visit; it improved statistically significantly to 0.74 at the 3rd-month visit (<i>p</i> = 0.025). The highest levels of CMT, CCT, TCA and CVI were at baseline. Statistically significant decreases were observed in CMT at month 3 and in choroidal parameters at month 1 (<i>p</i> &lt; 0.05, for each). Baseline and 1-year CMT values were positively correlated with 1-year BCVA (<i>p</i> = 0.001, r = 0.80 and <i>p</i> = 0.013, r = 0.67; respectively).</p> Conclusion <p>The acute phase of APMPPE disease is associated with increased retinal thickness and choroidal thickness, area, and vascularity. These parameters, which can be obtained non-invasively, can be valuable in the follow-up period.</p>