I have a similar problem. I turned off voxels and tried turning on ambient occlusion or what it was. But right after clicking on "apply" the screen turned black and that was it.

I tried to restart the game, which now was not really centerd in the screen, the menue was cut off and I couldn't even click on exit.

Now every time I try to start the game, nothing happens. I have the process of "anuketx64" in the background running, but the game isn't showing up. I reinstalled it four times and it will stay this way : /

I gave up for now.

Same problem for me

Edit : I tried unchecking the cinematics, but then I got a loading screen that didnt do much.

I tried changing a few options and exit the game properly ( until then I only killed the .exe ) and somehow now I can launch the game.

Yep i'm having the same issue.
I tried launching it by running the exe file in the folder and it told me I was missing a couple DLL's. I got them from elsewhere and now it just says it can't run the application.

Any help much appreciated.

This same problem, there is a shortcut in the game file instead exe file.

Strange thing for me:
It works on my Laptop.

BUT
I can't enable ambient occlusion here, too. The screen will turn black and that was it. But after a task killing action via task manager it works again.
Sadly, this does not count for my main big pc here : /

Edit:
I found out, that my game resolution is on a higher setting, than allowed by my monitor.
Maybe this helps somebody. Haven't found the config right now for it. Searching for it

Couldn't find the config, but managed to change the resolution in the menu.

BUT
I had to task manage me out (not closing the game, only pressed the key-combo to get out of it) and re-enter the game for applying changes and get a picture. But now it works for me!

I had the same problem. Game wouldn't launch and nothing happened. When i tried to open the game via icon in the folder i got an error with missing dll. The only thing that worked for me in the end was updating my windows 7. I would never solve this problem without contacting with gog support - they replied and resolved my problem very fast :-)

Had the same problem and managed to fix it: I am on Windows 7.

Steps:
1. go to your local install folder and try running the game launcher directly "Launch Blood - Fresh Supply"
2. if you get the error that the file "d3dcompiler_47.dll" is missing go to the following link and install the applicable version from the 'Workaround' section:

Niote: I can't post a link so do a simple search (google, Duck, etc) on the following (copy exactly) which will take you to the Microsoft page :

"The .NET Framework 4.7 installation is blocked on Windows 7, Windows Server 2008 R2, and Windows Server 2012 because of a missing d3dcompiler update"

Should work fine after that (did for me).