One of the best games I have played in recent time. I love the difficulty of the game and the diversity of the different items.
For the individual aspects of the game:
Difficulty: 5/5
You can enhance the difficulty by choosing modifiers. I am only playing on all of them selected, thus it is difficult.
Visuals: 4/5
Rather plain visuals, is true to its style and allows for decent visual clarity on projectiles and enemies.
Intuitive: 4/5
I did have to loon up / guess on some mechanics of the game. I really like the tooltips on the side of each item but it is sometimes (rarely) not enough to grasp all concepts.
Replayability: 5/5
Diversity in items and progression in general unlocks makes the replayability very high.


Negatives:
- Floor gameplay is very similar, normal enemies rarely have relevant nuances
- No way to save a run (i think)

I have wrote this just as a subjective insight and do not claim correctness on any statements. Enjoy playing if u decide to buy!