Just an FYI on what I needed to edit for it to run Fullscreen without fps issues and glitchy/color/seizures:

vsync = 1
frame_rest_suggest = 0
1600x1200 resolution - This was selectable via ZLaunch.

This is on a GeForce 1070 with a 4k TV with a standard 60hz refresh. Windows 10 Pro x64 all up to date.

Vsyncing my high refresh monitor is a different story. <_<