You've previously emphasised use of blocks in video codecs, as if it was some special distinguishing characteristic, but I wanted to explain that's an implementation detail, and novel video codecs could have different approaches to encoding P-frames. They don't have to code a literal 2D vector per macroblock that "moves pixels around". There are already more sophisticated implementations than that. It's an open problem of reusing previous frames' data to predict the next frame (as a base to minimize the residual), and it could be approached in very different ways, including use of neural networks that predict the motion. I mention NNs to emphasise how different motion compensation can be than just copying pixels on a 2D canvas.
Motion vectors are still motion vectors regardless of how many dimensions they have. You can have per-pixel 3D floating-point motion vectors in a game engine, or you can have 2D-flattened motion vectors in a video codec. They're still vectors, and they still represent motion (or its approximation).
Optical flow is just one possible technique of getting the motion vectors for coding P-frames. Usually video codecs are fed only pixels, so they have no choice but to deduce the motion from the pixels. However, motion estimated via optical flow can be ambiguous (flat surfaces) or incorrect (repeating patterns), or non-physical (e.g. fade-out of a gradient). Poorly estimated motion can cause visible distortions when the residual isn't transmitted with high-enough quality to cover it up.
3D motion vectors from a game engine can be projected into 2D to get the exact motion information that can be used for motion compensation/P-frames in video encoding. Games already use it for TAA, so this is going to be pretty accurate and authoritative motion information, and it completely replaces the need to estimate the motion from the 2D pixels. Dense optical flow is a hard problem, and game engines can give the flow field basically for free.
You've misread what I've said about optical flow earlier. You don't need to give me Wikipedia links, I implement codecs for a living.