Launcher: Prism Launcher 9.1
Minecraft: 1.20.1
Forge: 47.3.11
Oculus: 1.7.0
Create (flywheel is built in): 0.5.1.j
Flywheel Compat: 1.1.4
Geckolib Compat (unsure if this is relevant but it's here anyways): 1.0.1
Pixel Perfect: 1.5.2
Log: https://mclo.gs/qNJeCHZ
Mirror of this Issue on Pixel Perfect's Issues page: kolgushev/Pixel-Perfect-B#11

When Pixel Perfect is enabled, all animated Create components are rendered at large sizes directly ontop of the player, rather than where they're intended to be. The issue is fixed if the Flywheel Compat mod is disabled, at the cost of FPS.
For visuals and comparisons, see the following screenshots.

Comparisons:

no shaders enabled

Complementary Shaders - Reimagined (r5.3)

Pixel Perfect (1.5.2a)

Other screenshots: