The medical technology company has slipped into the red, posting a loss of $4.3m (£2.6m) for the year to September 30.
The Dunfermline-based company remained profitable at the operating level, however. Operating profit was $2.1m for the year, down from $11.7m the previous year.
The majority of its costs have come as a result of a restructuring carried out by Roy Davis, its chief executive.
Davis, who took the helm in November 2008, is the company's third chief executive since September 2006.
Optos, which sells retinal imaging technology, mainly to the US, reported a 2% rise in its pay-per- patient revenue, but sales of its devices dropped 71%.
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The restructuring cost Optos $6.3m in an exceptional charge, including the loss of more than 50 jobs.
Shares dropped on Wednesday, when the company's results were issued to the stock exchange.
However, Davis was fairly upbeat about the outlook for Optos, despite admitting that its core American market was not "really out of recession".
He pointed to Barack Obama's healthcare programme, saying:
"It is encouraging that it includes more wellness screening. That has to be good for a diagnostics company."
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Shares regained ground lost earlier in the week to finish at 95p - its highest price this year.