Review Sistematik Temuan Oftalmologi pada Pasien dengan COVID -19: Apa yang Harus Kita Ketahui?
Authors: Ariska Amalia Dwi , Poernomo Trining 
Published: August 2020

Latar belakang: SARS COV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) merupakan virus penyebab COVID-19 (Corona Virus Disesease-2019) yang pertama kali muncul di Kota Wuhan, Provinsi Hubei, Cina pada akhir Desember 2019. Sejak kemunculannya, SARS COV-2 menunjukkan penambahan jumlah pasien dan kematian yang pesat hingga lintas negara sehingga pada tanggal 11 Maret 2020, WHO (World Health Organization) mengumumkan bahwa COVID-19 dinyatakan sebagai global pandemi. Manifestasi COVID-19 dilaporkan sangat bervariasi, mulai dari gangguan sistem pernafasan, pencernaan, bahkan okular. Namun karena kelangkaan kasus dan situasi pandemi sehingga literatur mengenai manifestasinya pada mata sangat terbatas.

Tujuan: Artikel ini akan menelaah manifestasi klinis SARS-COV-2 pada mata, hubungannya dengan manifestasi sistemik, peran pemeriksaan PCR swab konjungtiva, dan terapi yang diberikan melalui review kualitatif sesuai dengan rekomendasi PRISMA.

Diskusi dan pembahasan masalah: Terdapat 12 dokumen yang ditelaah dalam review ini. Selain gejala pernafasan, COVID-19 juga dilaporkan dapat menyebabkan konjungtivitis dengan ciri umum seperti mata merah, kemosis konjungtiva, mata berair maupun manifestasi okular lain yang lebih jarang. Manifestasi okular dapat sebagai gejala tunggal, prodromal, maupun bersamaan dengan manifestasi sistemik, dan bisa menyebabkan gejala sisa berupa floaters. Terapinya pun bervariasi berdasarkan gejala. Pada kasus COVID-19 dengan konjungtivitis hasil pemeriksaan PCR swab konjungtiva bisa positif maupun negatif.

Kesimpulan: Dapat disimpulkan bahwa manifestasi okular pada pasien COVID-19 mungkin saja terjadi, dan hubungannya dengan manifestasi sistemik sangat bervariasi. Untuk terapi perlu dilakukan penelitian lebih lanjut, dan banyak faktor yang menyebabkan hasil PCR swab konjungtiva tidak sesuai dengan klinis pasien. Sehingga diharapkan agar setiap tenaga kesehatan untuk selalu waspada dan mengambil tindakan pencegahan yang memadai terlepas dari ada atau tidaknya manifestasi okular.

Kata kunci : SARS CoV-2; COVID-19; manifestasi okular; konjungtivitis; PCR; swab konungtiva.

 

 

Background: SARS COV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) is a virus that causes COVID-19 (Corona Virus Disesease-2019) which first appeared in Wuhan City, Hubei Province, China at the end of December 2019. Since its emergence, SARS COV-2 showed a rapid enhancement in the number of patients and death cases across countries, because of that, on March 11th, 2020, WHO (World Health Organization) announced that COVID-19 was declared as a global pandemic. The manifestations of COVID-19 were reported to be very varied, ranging from disorders of the respiratory, digestive, and even ocular system. However, due to the scarcity of cases and pandemic situations, the literature of its manifestations in the eyes is very limited.

Objective: This article will review the clinical manifestations of SARS-COV-2 in the eye, their relationship to systemic manifestations, the PCR examination of conjunctival swab’s roles, and therapy provided through qualitative reviews according to PRISMA recommendations.

Discussion: There were 12 documents reviewed in this study. In addition to respiratory symptoms, COVID-19 was also reported to cause conjunctivitis with common features such as red eye, conjunctival chemosis, watery discharge or other ocular manifestations that were less common. Ocular manifestations could be a single symptom, prodromal, or concurrent with systemic manifestations, and could cause sequelae in the form of floaters. Its treatment also varied based on symptoms. In the case of COVID-19 with conjunctivitis the results of conjunctival swab PCR examination could be positive or negative.

Conclusion: It can be concluded that ocular manifestations in COVID-19 patients may occur, and their relationship with systemic manifestations is varies. For therapy, further research is needed, and many factors cause the conjunctival swab PCR results to be incompatible with the patient's clinical course. We hope that every health worker must be aware and take precautions regardless of the presence or absence of ocular manifestations.

Keywords: SARS CoV-2; COVID-19; ocular manifestations; conjunctivitis; PCR; conjunctival swab.