One of my favorite games. That said, I can't give it a perfect score as I think the end-game difficulty is more RNG based than the Binding of Isaac. The dungeons before they start resetting your progress are all great though.
Additionally I think certain additions this game adds - particularly in a sidequest about Grovyle - actually take away from the game's extremely strong narrative. But I like to just take that as a "What if". It doesn't ruin the QoL it adds over Time/Darkness so yeah, play this masterpiece already.