The study examined the association between the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) and age-related macular degeneration (AMD). The analysis was based on data from 4,017 participants from the US NHANES database and 96 patients from the Chinese PHFT Hospital. The results showed that people with AMD had a significantly lower NHHR compared to those without AMD (p < 0.01). A one-unit increase in NHHR was associated with a 33.1% to 76.8% reduction in AMD risk in the highest tertile. Curve analyzes confirmed a negative correlation between NHHR and the incidence of AMD (p < 0.05). The association was consistent across different subgroups of participants. The authors suggest that NHHR may serve as an independent indicator of AMD risk, but further large-scale and prospective studies are needed for confirmation.