It turns out this is a system problem and not something with Opera. All browsers are doing it including firefox and chrome. I am still trying to figure out what is wrong, but it appears to be an explorer thing rather than an Opera issue.

Edit - Included a screenshot if anyone is interested.
http://imgur.com/a/8UnbF

Whenever I go to open or save any files the dialog box opens up severely corrupted. The folders are shown with the correct icons but the text appears to be replaced with all spaces and the UI buttons at the bottom of the dialog are completely missing.

I have used Opera quite a long time and this recently started, I am not sure if there was a significant update recently, I am using 47.0.2631.71, tried uninstall/reinstall.