optimum settings

[SEE]

HardwareShaders=1 (for perfect)
LandGeom =3
Forests= 3 (try it and see if FPS is affected)
Water=3 or 4 (for Nvidia)

Effects=1 (game was never optimised for =2 from what I have read)
TexFlags.TexCompressARBExt=1 (IIRC, this is only set to 1 if texture compression is used and you have none, see what others say)
Video Setup=17 (Custom) not sure if that will make much difference

There are some excellent threads that detail the best settings for Nvidea GFX in far greater detail than the few I have listed above.