I just tested out Kega Fusion 3.64 in Windows 10 and it worked just fine without requiring any tweaks. My video card isn't anything special, just a Nvidia GeForce GT 440.
The only thing I could suggest is hitting Alt-9 once or twice to make sure you don't have the zoom feature enabled.
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I used to be a ROM hacker like you. Then I took an arrow to the feels.
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