ENVISU SPECTRAL DOMAIN OPHTHALMIC IMAGING SYSTEM (SDOIS)

K120057 · Bioptigen, Inc. · HLI · May 11, 2012 · Ophthalmic

Device Facts

• Record ID: K120057
• Device Name: ENVISU SPECTRAL DOMAIN OPHTHALMIC IMAGING SYSTEM (SDOIS)
• Applicant: Bioptigen, Inc.
• Product Code: HLI · Ophthalmic
• Decision Date: May 11, 2012
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 886.1570
• Device Class: Class 2
• Attributes: Pediatric

Intended Use

Bioptigen Envisu™ Spectral Domain Ophthalmic Imaging System (Envisu™ SDOIS) is intended to acquire, process, display and save depth-resolved images of ocular tissue microstructure using Spectral Domain Optical Coherence Tomography (SDOCT). The Envisu™ SDOIS is indicated for use as an aid in the diagnosis of physiologic and pathologic conditions of the eye through non-contact optical imaging. Imaging of the various tissues of the eye is supported through the use of interchangeable lenses. It is indicated for use on patient populations from premature and neonatal infants to adult, and is suitable for patients ambulatory or confined. The system is indicated for use in upright or supine imaging, handheld or mounted, and is suited for imaging patients under anesthesia.

Device Story

Envisu SDOIS is a mobile, non-contact, near-infrared spectral domain optical coherence tomography (SD-OCT) system. It uses a low-power broadband SLED light source (760-930 nm) and a spectrometer with a line-scan camera to capture backscattered radiation from ocular tissues. The system transforms these signals into depth-resolved images of retinal, corneal, scleral, and conjunctival microstructures. Operated by clinicians in clinical settings, the device features a lightweight handheld scanner or a mounted configuration for patient comfort. InVivoVue Clinic software processes and displays images, allowing for registration, averaging, manual caliper measurements, 3D visualization, and report generation. Output assists clinicians in diagnosing ocular conditions by visualizing tissue scattering properties. Benefits include flexible imaging for pediatric, supine, or anesthetized patients without requiring a chin rest.

Clinical Evidence

No independent clinical trials conducted by the manufacturer. Evidence relies on a review of peer-reviewed clinical literature, which reported the handheld SDOIS as a safe, non-invasive, and effective method for evaluating the eye in pediatric populations. Bench testing included electrical safety (IEC 60601-1), electromagnetic compatibility (IEC 60601-1-2), optical emission safety (IEC 60825-1, ISO 15004-2), image resolution, and software validation.

Technological Characteristics

Spectral Domain OCT; SLED light source (760-930 nm); Class 1 LED; Galvanometric mirror scanner; Transmission grating/spectrometer detection; 32,000 A-scans/s; Axial resolution <4-6 µm; Lateral resolution 9-25 µm; Imaging depth up to 3.4 mm (air); Windows-based software (InVivoVue Clinic); Mobile cart with UPS; Handheld or mounted form factor.

Indications for Use

Indicated for aid in diagnosis of physiologic and pathologic eye conditions via non-contact optical imaging of ocular tissue microstructure. Applicable to all patient populations from premature and neonatal infants to adults; suitable for ambulatory, confined, or anesthetized patients.

Regulatory Classification

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.

Special Controls

*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.

Predicate Devices

• Spectral Domain Ophthalmic Imaging System (SDOIS) (K063343)

Submission Summary (Full Text)

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K120057

New Traditional 510(k)

bioptigen

MAY 1 1 2012

#### 510(K) SUMMARY (PER 21 CFR 807.92) -

Date Prepared: December 23, 2011

#### SUBMITTER INFORMATION

| 510(k) Owner and Device Manufacturer: | Bioptigen, Inc. |
|---------------------------------------|--------------------------------------------------|
| Registration Number: | 3006809695 |
| Address: | 104 T.W. Alexander, Building 2, Durham, NC 27709 |
| Phone: | [phone] |
| Fax: | [phone] |

Contact:

Dawn Reilly-O'Dell, RAC Full Circle Regulatory Consulting, LLC [phone] (Phone) [e-mail] (Email)

#### DEVICE IDENTIFICATION

Trade or proprietary name:

Envisu™ Spectral Domain Ophthalmic Imaging System (SDOIS) Spectral Domain Optical Coherence Tomography (SD-OCT) Common or usual name: Ophthalmoscope, AC-powered; Classification name: Tomography, Optical Coherence ни, ово Product Codes: 886.1570 Regulation Number:

#### INTENDED USE

Bioptigen Envisu™ Spectral Domain Ophthalmic Imaging System (SDOIS) is intended to acquire, process, display and save depth-resolved images of ocular tissue microstructure using Spectral Domain Optical Coherence Tomography (SD-OCT).

The Envisu SDOIS is indicated for use as an aid in the diagnosis of physiologic and pathologic conditions of the eye through non-contact optical imaging of the various tissues of the eye is supported through the use of interchangeable lenses. It is indicated for use on patient populations from premature and neonatal infants to adult, and is suitable for patients ambulatory or confined. The system is indicated for use in upright or supine imaging, handheld or mounted, and is suited for imaģing patients under anesthesia.

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New Traditional 510(k)

# bioptigen

#### SUBSTANTIAL EQUIVALENCE

The Envisu™ SDOIS is substantially equivalent to the predicate SDOIS in technology, safety and effectiveness. The Envisu™ SDOIS incorporates a number of design changes, but it shares the same fundamental spectral domain optical coherence tomography imaging technology and incoherent superluminiscent light emitting diode technology as the predicate SDOIS. The differences between the 2006 predicate, K063343, and the current subject SDOIS are the following design modifications incorporated to enhance device usability and performance:

- . Upgraded spectrometer line-scan camera allowing 32,000 A-scans/second for faster imaging speeds with no increase in patient irradiance
- . Added VHR light source option for improved axial resolution without increase in patient irradiant exposure
- . Revised scan head with enhanced ergonomics including handheld operation for improved clinical flexibility and patient comfort
- Mobile transport cart with Uninterruptable Power Supply (UPS)
- . Increased computer memory and processing speed
- . Additional objective lens options for cornea and related anterior imaging
- Updated Information for Use labeling to parallel the system changes and a new training manual to address use of the handheld scanner
- Added spectrometer design option for increased imaging depth to 3.4 mm in air (2.5 mm in tissue) for greater depth of imaging field
- . Upgraded IVVC software post-processing and visualization functionality including four new. features, which are the option to register and average multiple frames, the manual Onscreen Calipers, the 3D view and the option to generate Word-based reports

| Predicate Device | 510(k) Holder | 510(k) | Clearance Date |
|-----------------------------------------------------|-----------------|---------|-------------------|
| Spectral Domain Ophthalmic Imaging System (SDOIS) . | Bioptigen, Inc. | K063343 | December 13, 2006 |

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New Traditional 510(k)

#### Envisu SDOIS

## bioptigen

Predicate

SDOIS

#### Technological Comparison:

#### Medical Device

Indications for Use

Spectral Domain Imaging The System (SDOIS) is intended to acquire, process, display and save depth-resolved images of ocular microstructure tissue using Spectral Domain Optical Coherence Tomography (SD-OCT). It is primarily intended for the imaging of retinal tissue, but the cornea, sclera and conjunctiva can also be imaged by changing the focal position. Indications for use evaluation include the of ophthalmic tissue in routine clinical examinations and as an aid in the diagnosis of conditions that affect the optical scattering properties of ocular tissue.

#### Subject Envisu™ SDOIS

Bioptigen Envisu™ Spectral Domain Ophthalmic Imaging system is intended to acquire, process, display and save depth-resolved images of ocular tissue microstructure using Spectral Domain Optical Coherence Tomography (SDOCT). The Envisu™ SDOIS is indicated for use as an aid in the diagnosis of physiologic and pathologic conditions of the eye through non-contact optical imaging. Imaging of the various tissues of the eye is supported through the use of interchangeable lenses. It is indicated for use on patient populations from premature and neonatal infants to adult, and is suitable for patients ambulatory or confined. The system is indicated for use in upright or supine imaging, handheld or mounted, and is suited for imaging patients under anesthesia.

#### Categories

Method of Operation Light Source

Light Source Classification

Optical Power

Resolution, Lateral

Resolution, Axial

Depth Range (in tissue/air)

Scanner Type

#### Specifications

| SD-OCT | Same as predicate | |
|-------------------------------------------------------|----------------------------------------------------------------|--|
| SLED | SLED | |
| High Resolution (HR) | HR: Same as predicate<br>VHR: Very High Resolution | |
| Class 1 LED | HR: Same as predicate | |
| | VHR: Class 1 LED | |
| < 750 µW at cornea | Same as predicate | |
| Retina: 20 µm in tissue<br>Anterior: ~25 um in tissue | Retina: same as predicate<br>Anterior Segment: 9, 12 and 25 um | |
| < 6 um in tissue | HR: Same as predicate<br>VHR: <4 µm in tissue | |
| 1.7 / 2.2 mm | Model C2200: 1.7 /2.3<br>Model C2300: 2.5 / 3.4 mm | |
| Galvanometric mirror pair | Same as predicate | |

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| Scan Patterns Available | Line, rectangular volume, circle, concentric rings, radial lines | Same as predicate |
|-------------------------|----------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------|
| Scan Pixels | Axial (depth): 512 or 1024<br>Lateral : User Selectable<br>Maximum 5,000 A-scans / B-scan<br>Maximum 150,000 total A-scans | Same as predicate |
| Scan Rate | 20,000 A-scans/s | 32,000 A-scans/s |
| Detection | Transmission Grating<br>Spectrometer / Line-Scan Camera | Same as predicate |
| Scanner Ergonomics | Mounted (tabletop) | Same as predicate or handheld |
| Patient Interface | Chin Rest Assembly | Same as predicate or None (Chin<br>Rest Assembly now optional) |
| Footprint | Stationary: 15" x 18"<br>Engine, 12" x 15" scanner | Mobile: 24" x 22" x 37.5" |
| Scanner Dimensions | 12" (h) x 6" (w) x 9"(d) | 7" (h) x 3" (w) x 9" (d)<br>h: incl handle / d: incl lens<br>Weight: ≤ 3.5 lbs |
| Software | InVivoVue™ 1.5 | InVivoVue™ Clinic 1.4 |
| Operating System | Windows XP | Same as predicate |
| Processor | Dual 3.4 GHz Xeon | Dual 2.0 GHz Quad Core |
| Memory | 2 GB | 4 GB |

#### DEVICE DESCRIPTION

New Traditional 510(k)

The Envisu™ SDOIS is a non-contact, non-invasive and mobile ophthalmic imaging device that can be used to view ocular tissue physiology and pathology through the interaction of light with the optical scattering properties of structures of the eye.

Like its predicate, the Envisu™ Spectral Domain Ophthalmic Imaging System (SDOIS) is a nearinfrared scanning imaging medical device designed to capture depth-resolved images of ocular tissue microstructure. It is available in "high (HR)" and "very-high (VHR)" resolution based on the SLED light source chosen. Each option includes an optical engine, a scanning head, an interchangeable lens set, a computer and the InVivoVue™ Clinic software for imaging of ocular tissue microstructures. The smaller system footprint and mobile security cart easily accommodate any clinical environment.

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| Envisu™<br>System | Maximum<br>Detector<br>Bandwidth (nm) | Maximum Image<br>Depth (mm in<br>tissue)1 | Pixel Resolution<br>(µm in tissue, 1024<br>pixels full depth) | Detection Type |
|-------------------|---------------------------------------|-------------------------------------------|---------------------------------------------------------------|-----------------------------------|
| C2200 | 160 | 1.7 | 1.6 | Transmission |
| C2300 | 110 | 2.5 | 2.4 | Spectrometer,<br>Line-scan Camera |

The optical engine includes a low power broadband LED light source with bandwidths of 40 - 100 nm operating in the wavelength range between 760 - 930 nm and a spectrometer that detects backscattered radiation. The scanning head is flexibly designed to be used mounted or handheld for the mutual convenience and comfort of patient and ciinician. Handheld use of the light-weight (< 3.5 lbs), compact handheld scanner makes it possible to image pediatric patients, supine patients, or any patient that finds it difficult to sit upright or where it is clinically preferable to image without the constraint of a chin rest. Tabletop, chin-rest mediated imaging is enabled though a mounting accessory.

#### NON-CLINICAL PERFORMANCE AND SAFETY DATA

IEC-60601-1 electrical, IEC 60601-1-2 electromagnetic compatibility, IEC 60825-1 and ISO 15004-2 Group I optical emission and Class 1 LED safety, image resolution, image comparison and software validation testing have been conducted in accordance with established protocols. All testing has demonstrated compliance with applicable product requirements.

#### CLINICAL LITERATURE REVIEW

A review of existing peer-reviewed clinical literature publications has been completed. Published clinical data reported that the handheld SDOIS is a safe, noninvasive and effective method for evaluation of the eye for pediatric populations. Clinical testing has not been conducted independently by Bioptigen.

#### CONCLUSION

New Traditional 510/k)

The Envisu™ SDOIS has the same fundamental technology, method of operation and technological characteristics as the predicate SDOIS. It introduces new characteristics of mobility and ergonomic utility, including handheld imaging operation, which impact indications for use. Results of performance and safety testing verify that these modifications present no new issues regarding the Envisu™'s safety or effectiveness, and that the Envisu™ SDOIS remains a Class 1 LED , group 1, nonhazardous device eye safe under all operating conditions. In conclusion, the Envisu™ SDOIS is substantially equivalent to the predicate SDOIS device when used as labeled.

¹ Values are approximate, based on an average refractive index of 1.38

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Image /page/5/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is circular and contains the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. In the center of the circle is an abstract image of an eagle.

#### DEPARTMENT OF HEALTH & HUMAN SERVICES

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002

MAY 1 1 2012

Bioptigen, Inc. c/o Ms. Dawn Reilly-O'Dell, RAC Principal Consultant Full Circle Regulatory Consulting, LLC 104 T.W. Alexander Drive, P.O. Box 13569 Durham, North Carolina 27709

#### Re: K120057

Trade/Device Name: Envisu Spectral Domain Opthalmic Imaging System (SDOIS) C2200 and C2300 Regulation Number: 21 CFR 886.1570 Regulation Name: Ophthalmoscope Regulatory Class: Class II Product Codes: HLI, OBO Dated: May 4, 2012 Received: May 7, 2012

Dear Ms. Reilly-O'Dell:

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, FDA may publish further announcements concerning your device in the Federal 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. You must

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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 electronic product radiation control provisions (Sections 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 go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. 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/ReportaProblem/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 [phone] or [phone] or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

机_

Sincerely yours,

Kesia Alexander

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

Enclosure

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### INDICATIONS FOR USE STATEMENT

510(k) Number (if known):

K120057

Device Name:

Envisu "M SDOIS (Spectral Domain Ophthalmic Imaging System)

Indications for Use:

Bioptigen Envisu™ Spectral Domain Ophthalmic Imaging System (Envisu™ SDOIS) is intended to acquire, process, display and save depth-resolved images of ocular tissue microstructure using Spectral Domain Optical Coherence Tomography (SDOCT). The Envisu™ SDOIS is indicated for use as an aid in the diagnosis of physiologic and pathologic conditions of the eye through non-contact optical imaging. Imaging of the various tissues of the eye is supported through the use of interchangeable lenses. It is indicated for use on patient populations from premature and neonatal infants to adult, and is suitable for patients ambulatory or confined. The system is indicated for use in upright or supine imaging, handheld or mounted, and is suited for imaging patients under anesthesia.

Prescription Use _____________________________________________________________________________________________________________________________________________________________ (Part 21 CFR 801 Subpart D)

AND/OR

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

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE OF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Page 1 of 1

(Division Sign-Off) Division of Ophthalmic, Neurological and Ear, Nose and Throat Devices

K120057
310(k) Number

Bioptigen, Inc. ~ Confidential

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