K Number
K133892
Device Name
IVUE 500
Manufacturer
Date Cleared
2014-03-19

(89 days)

Product Code
Regulation Number
886.1570
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The iVue 500 with normative database is an optical coherence tomography system intended for in vivo imaging, axial crosssectional, three-dimensional imaging and measurement of anterior and posterior ocular structures. The iVue 500 with normative database is a non-contact, high resolution tomographic imaging device. It is intended for in vivo imaging, axial cross-sectional and three-dimensional imaging and measurement of anterior and posterior ocular structures, including retina, retinal nerve fiber layer, ganglion cell complex (GCC), optic disc, cornea, and anterior chamber of the eye. The iVue 500 with normative database is a quantitative tool for the comparison of retinal nerve fiber layer, ganglion cell complex, and optic disc measurements to a database of known normal subjects. The iVue 500 with normative database is indicated for use as a device to aid in the diagnosis, documentation, and management of ocular health and diseases in the adult population. (identical to predicate device)
Device Description
The iVue 500 is a modification of its predicate device iVue with Normative Database (NDB) (K121739). The intended use, system performance, sub-assemblies, and key components of the iVue with NDB are all the same as the iVue with NDB. The intent of this redesign was to make the iVue a more compact desktop device, so it is more convenient to use and set-up in a typical office. Additionally operation via touchscreen or mouse driven technology, makes it simpler for a technician to use. The iVue 500 is a non-invasive device for imaging the cornea, anterior chamber, and retinal tissue structure with micrometer range resolution.
More Information

Not Found

No
The summary describes a standard OCT imaging system with a normative database for comparison, and there is no mention of AI or ML in the intended use, device description, or performance studies.

No.
The device is intended for imaging and diagnosis of ocular structures, not for treatment or therapy.

Yes

Explanation: The "Intended Use / Indications for Use" section explicitly states, "The iVue 500 with normative database is indicated for use as a device to aid in the diagnosis, documentation, and management of ocular health and diseases in the adult population."

No

The device description explicitly states it is a "non-contact, high resolution tomographic imaging device" and mentions "moving the scanner head," indicating it includes hardware components for image acquisition.

Based on the provided text, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases or other conditions.
  • Device Description: The iVue 500 is described as an "optical coherence tomography system intended for in vivo imaging". "In vivo" means performed or occurring within a living organism.
  • Imaging Modality: The input imaging modality is Optical Coherence Tomography (OCT), which is a non-invasive imaging technique performed directly on the patient's eye.
  • Anatomical Site: The device images structures within the eye (retina, cornea, etc.), not samples taken from the eye or body.

The device is a medical imaging device used for direct examination of the eye, not for testing samples outside the body.

N/A

Intended Use / Indications for Use

  • Intended Use: The iVue 500 with normative database is an optical coherence tomography system intended for in vivo imaging, axial crosssectional, three-dimensional imaging and measurement of anterior and posterior ocular structures.
  • Indications for Use: The iVue 500 with normative database is a non-contact, high resolution tomographic imaging device. It is intended for in vivo imaging, axial cross-sectional and three-dimensional imaging and measurement of anterior and posterior ocular structures, including retina, retinal nerve fiber layer, ganglion cell complex (GCC), optic disc, cornea, and anterior chamber of the eye. The iVue 500 with normative database is a quantitative tool for the comparison of retinal nerve fiber layer, ganglion cell complex, and optic disc measurements to a database of known normal subjects. The iVue 500 with normative database is indicated for use as a device to aid in the diagnosis, documentation, and management of ocular health and diseases in the adult population.

Product codes (comma separated list FDA assigned to the subject device)

HILI

Device Description

The iVue 500 is a modification of its predicate device iVue with Normative Database (NDB) (K121739). The intended use, system performance, sub-assemblies, and key components of the iVue with NDB are all the same as the iVue with NDB. The intent of this redesign was to make the iVue a more compact desktop device, so it is more convenient to use and set-up in a typical office. Additionally operation via touchscreen or mouse driven technology, makes it simpler for a technician to use. The iVue 500 is a non-invasive device for imaging the cornea, anterior chamber, and retinal tissue structure with micrometer range resolution.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Optical Coherence Tomography (OCT)

Anatomical Site

anterior and posterior ocular structures, including retina, retinal nerve fiber layer, ganglion cell complex (GCC), optic disc, cornea, and anterior chamber of the eye.

Indicated Patient Age Range

adult population

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Testing was performed to verify design, and showed there were no new questions of safety or effectiveness with the subject device, This testing included electrical safety testing, electrical emissions testing, as well as bench. Bench testing demonstrated that the iVue 500 is able to align to appropriate working distance on both left and right eyes within the predefined acceptance criteria. The bench test of iVue 500 utilizing 2 model eyes provides evidence that the software assisted motorized iVue 500 is able to complete the initial alignment of moving the scanner head to working position and to align the scanner head with the pupil within ±1mm tolerance. These are the general requirements to align a scanner to be able to capture an OCT image. Also the iVue 500 is able to move scanner head between right and left eyes.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K121739

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 886.1570 Ophthalmoscope.

(a)
Identification. An ophthalmoscope is an AC-powered or battery-powered device containing illumination and viewing optics intended to examine the media (cornea, aqueous, lens, and vitreous) and the retina of the eye.(b)
Classification. Class II (special controls). The device, when it is an AC-powered opthalmoscope, a battery-powered opthalmoscope, or a hand-held ophthalmoscope replacement battery, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 886.9.

0

510(k) Summary Optovue iVue 500 K133892

MAR 1 9 2014

This 510(k) summary for the iVue 500 is submitted in accordance with the requirements of SMDA 1990 and 21 CFR 807.92

CategoryComments
Sponsor:Optovue, Inc.
2800 Bayview Pkwy
Fremont, CA 94538
Correspondents:Michael Sarrasin, Esq.,
VP, Regulatory Affairs and Quality Assurance
michael_sarrasin@optovue.com
Manufacturer:Optovue, Inc.
2800 Bayview Parkway
Fremont, CA 94538
Device Common Name:Optical Coherence Tomography (OCT) System
Device Proprietary Name:iVue 500
Device ClassificationCI II, HLI, 21 CFR §886.1570
Predicate DeviceIVue with NDB, K121739
Predicate Device ManufacturerOptovue, Inc.
Predicate Device ClassificationCI II, HLI, 21 CFR §886.1570

Date Summary was Prepared: January 7, 2014

Device Description: The iVue 500 is a modification of its predicate device iVue with Normative Database (NDB) (K121739). The intended use, system performance, sub-assemblies, and key components of the iVue with NDB are all the same as the iVue with NDB. The intent of this redesign was to make the iVue a more compact desktop device, so it is more convenient to use and set-up in a lypical office. Additionally operation via touchscreen or mouse driven technology, makes it simpler for a technician to use.

  • Intended Use: The iVue 500 with normative database is an optical coherence tomography system intended for in vivo imaging, axial crosssectional, three-dimensional imaging and measurement of anterior and posterior ocular structures.
  • Indications for Use: The iVue 500 with normative database is a non-contact, high resolution tomographic imaging device. It is intended for in vivo imaging, axial cross-sectional and three-dimensional imaging and measurement of anterior and posterior ocular structures,

1

including retina, retinal nerve fiber layer, ganglion cell complex (GCC), optic disc, cornea, and anterior chamber of the eye. The iVuc 500 with normative database is a quantitative tool for the comparison of retinal nerve fiber layer, ganglion cell complex, and optic disc measurements to a database of known normal subjects. The iVuc 500 with normative database is indicated for use as a device to aid in the diagnosis, documentation, and management of ocular health and diseases in the adult population. (identical to predicate device)

  • Technological Characteristics: The iVue 500 is a non-invasive device for imaging the cornea, anterior chamber, and retinal tissue structure with micrometer range resolution.
  • Comparison to Predicate Device: The iVue 500 is a modification of its predicate device iVue with Normative Database (NDB) (K121739). The intended use, system performance, sub-assemblies, and key components of the iVue 500 with NDB are all the same as the iVue with NDB.
DevicePredicateCurrent
510(k) Reference:K121739K133892
Intended Use:The iVue with Normative
Database is an optical
coherence tomography
system intended for in vivo
imaging, axial cross-
sectional, three-
dimensional imaging and
measurement of anterior
and posterior ocular
structures.Same
Device Description:Optical Coherence
Tomography (OCT)
SystemSame
Device Common Name:Optical Coherence
Tomography (OCT)
SystemSame
Device Classification:Class II HLI
(21 CFR 886.1570)Same
Manufacturer:Optovue, Inc.Same

Summary of Testing: Testing was performed to verify design, and showed there were no new questions of safety or effectiveness with the subject device, This testing included electrical safety testing, electrical emissions testing, as well as bench. Bench testing demonstrated that the

2

iVue 500 is able to align to appropriate working distance on both left and right eyes within the predefined acceptance criteria.

The bench test of iVue 500 utilizing 2 model eyes provides evidence that the software assisted motorized iVue 500 is able to complete the initial alignment of moving the scanner head to working position and to align the scanner head with the pupil within ±1mm tolerance. These are the general requirements to align a scanner to be able to capture an OCT image. Also the iVue 500 is able to move scanner head between right and left eyes.

| Retina

ModeRangeAverageCriteriaResults
Working
distance20.3-22mm21.3+/- 1mmPass
centering0-.2mmn/a+/- 1mmPass
Pupil
distance66.1-
66.6mmn/a+/- 1mmPass

| Cornea

ModeRangeAverageCriteriaResults
Working
distance16.4-
17.3mm16.7+/- 1mmPass
centering0-.1mmn/a+/- 1mmPass
Pupil
distance65.7-
66.8mmn/a+/- 1mmPass

Conclusion:

As described in this 510(k) Summary, all necessary testing and analyses were completed on the iVue 500 to ensure that the device is substantially equivalent to the identified predicate device.

3

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609

Silver Spring, MD 2093-0002

March 19, 2014

Optovuc, Inc. % Mr. Michael Sarrasin, Esq. Vice President, Regulatory Affairs & Quality Assurance 2800 Bayview Drive Fremont, CA 94538

Rc: K133892

Trade/Device Name: iVue 500 Regulation Number: 21 CFR 886.1570 Regulation Name: Ophthalmoscope Regulatory Class: Class II Product Code: HILI Dated: February 19, 2014 Received: February 20, 2014

Dear Mr. Sarrasin:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, F12A may publish further announcements concerning your device in the Eederal Register.

Please be advised that FDA 's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies.

4

Page 2 - Mr. Michael Sarrasin, Esg.

You must comply with all the Act's requirements, including, but not limited to: Registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820); and if applicable, the clectronic product radiation control provisions (Scctions 531-542 of the Act); 21 CFR 1000-1050.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Small Manufacturers, International and Consumer Assistance at its tollfree number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.lda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807,97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportalProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours.

Deborah L. Falls -S

for Malvina B. Eydelman, M.D. Director Division of Ophthalmic and Ear. Nose and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

5

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

Form Approved: OMB No. 0910-0120 Expiration Date: December 31, 2013 See PRA Statement on last page.

510(k) Number (if known)

K133892

Device Name

iVue 500

Indications for Use (Describe)

The iVue 500 with normative database is a non-contact, high resolution tomographic imaging device. It is intended for in vivo imaging, axial cross-sectional and three-diment of anterior and posterior and posterior ocular structures, including reinal nerve fiber layer, ganglion cell complex (GCC), optic disc, cornea, and anterior chamber of the eye. The iVue 500 with normalive database is a quantitative tool for the comparison of retinal nerve fiber layer, ganglion cell complex, and optic disc measurements to a database of known normal subjects. The iVue 500 with normative database is indicated for use as a device to aid in the diagnosis, documentation, and management of ocular health and diseases in the adult population.

Type of Use (Select one or both, as applicable)

[x] Prescription Use (Part 21 CFR 801 Subpart D)

] Over-The-Counter Use (21 CFR 801 Subpart C)

PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.

FOR FOR FOR FOR FOR FOR FOR FOR FOR FOR FOR FOR FOR FOR FOR FOR FOR FOR FOR FOR Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

Rahul K. Ram -S (Affiliate) 2014.03.13 15:02:55 -04'00'

FORM FDA 3881 (9/13)