A FEW TIPS THAT HAVE HELPED ME WITH LAG AND PERFORMANCE

It seems like the biggest issue causing lag for me isnt anything graphical but audio

many times things happen on screen faster than the audio can play and this leads to lag for me
when a NPC talks during or right before battle it always causes unplayable lags

I tried all of the suggestions of:
disabling v-sync
open port of POE on my router
deleting shader cache and moving it
windowed and windowed fullscreen
looking for audio driver updates
disabling nvidia audio drivers
update windows store
update windows

all of which had some marginal success



but what has worked best were 3 things

1st

deleting my DNS cache
this made my overall internet experience soooo much better browsers load faster videos less choppy and so on

to do this open a command prompt(push windows key and type CMD and open as admin)

then type ipconfig/flushdns


2nd
is a bit of a P.I.T.A. to remember

shutdown my computer and restart before every new instance of gameplay
meaning before you play or play again shutdown your computer(not restart)
and start it again

The game would cause hard crashes and I noticed after it did it would play better

I noticed when I do this the audio plays much better and it doesnt skip during the title screen

since I started doing this every time no crashes
so this makes me believe that even when you close the game something is still loaded somewhere and doesnt rest until I shut all the way down and the more I play without doing so it seemed to build up.


3rd
going into the production config file in my documents and changing the dialog sound to false (stops NPCs from interrupting and lagging play)




this isnt a magic bullet but has made the game at least playable
hopefully this helps