Game (world) design (and art in general) is about accommodating and working
with the constraints of the medium. Make a realistic (or fantastic) desert game today, if you can't get the water right. Make a great simulator for the oculus (eg: Elite: Dangerous) rather than trying to make a roller-coaster simulator if your user won't be able to get multi-million-dollar 360-degree rotating simulation chairs (think NASA style stuff).
As for a "VR" river, there's nothing wrong with filming a real river with a 360 degree camera, and then augment that scene, rather than "building a river". A real river on a virtual Mars, might look better than a virtual river on a virtual world.
Of course you can dream up a game that hard to bring to life exactly as you envision it using current technology. That doesn't mean new technology doesn't open up a few new possibilities. If you run into problems thinking big and complicated, try thinking smaller and simpler. I'm sure a Populus style game would be a lot of fun with the DK2 (isometric sandbox god simulator game with slightly cartoony graphics). Why does it have to be realistic?