Characteristics and Age-Related Changes in Orbital Fat Protrusion in East Asians: A Retrospective Three-Dimensional Computed Tomography-Based Study

Background East Asians have a high prevalence of orbital fat protrusion (eye bags) from a young age, but underlying changes over time have not been extensively assessed. Objectives To evaluate age-related changes in orbital fat protrusion and the positional relationship between the eye globe and cheek in East Asians. Methods This was a retrospective analysis of adults undergoing head and neck computed tomography at a single center. Various parameters were assessed relative to a pupil-centered reference line, including the most anterior points of: the globe (A); inferior orbital fat pad (F); infraorbital rim (O); and cheek (C). Distances AF, AO, AC, and FO (eye bag prominence) were calculated. The East Asian group was also compared with historical Caucasian data via 1:1 matching. Results The East Asian population included 224 participants (age range: 20–79years). Orbital fat (AF) protruded among young individuals, increasing with age; inferior orbital rim position (AO) remained unchanged over time; the cheek (AC) showed a high prevalence of negative vectors from youth, and increased projection with advancing age; eye bags (FO) were present even in young individuals and became somewhat more pronounced with aging. By comparison, the matched Caucasian cohort (n=22) showed significant decreases in AO and AC and increases in FO with age. Conclusions From a young age, East Asians exhibit a high prevalence of orbital fat protrusion. This is largely attributable to inherent structural factors, whereas such protrusion in Caucasians may be primarily due to age-related retrusion of the orbital rim and cheek.