Sex estimation using orbital measurements in the Croatian population

The aim of this study was to test the sexual dimorphism of orbital measurements in the Croatian population using multi-slice computed tomography (MSCT) images. We have retrospectively taken 414 head CT scans of adults from Croatian clinical hospitals in Split and Zagreb (214 males and 200 females) with slice thickness < 1 mm and no pathological or traumatic changes that could affect the measurements. DICOM files were imported into Stratovan Checkpoint Software and viewed in 2D and 3D using semi-transparent 3D volume rendering. Eight standard measurements were calculated based on twelve orbital landmarks (six paired). Principal component analysis (PCA) was used to explore sexual and regional differences, and linear discriminant analysis was used to develop sex classification models. The PCA showed separation based on sex and region, and additional analysis demonstrated that females and males in Split and Zagreb differed in four orbital measurements (P ≤ 0.001). Only those measurements that did not show regional differences were further analyzed, and all showed statistically significant sexual dimorphism. The accuracy of univariate functions for sex estimation ranged from 53.43 to 71.88%, and for multivariate function, the accuracy was 73.45%. The orbital measurements of the Croatian population showed restricted forensic significance for sex classification. On the other hand, we have shown that they can have a potential for exploring the inter- and intra-population differences.