I just re-read the "Doom3 Source Code Review" by Fabien Sanglard (http://fabiensanglard.net/doom3/) and apparently they don't use the Standard C++ library. "The engine does not use the Standard C++ Library: All containers (map,linked list...) are re-implemented but libc is extensively used."
I certainly feel that there is room for improvement, like optimizing the GC, define a GC-free subset of Phobos etc. But it seems like if you're writing really performance critical realtime software most likely you've to implement everything bottom up to get the level of control.
Secondly it seems like it's most often cheaper to just throw faster hardware at a problem.
"You can do tricks to address any one of them; but I pretty strongly believe that with all of these things that are troublesome in graphics, rather than throwing really complex algorithms at them, they will eventually fall to raw processing power."(http://fabiensanglard.net/doom3/interviews.php)